Individual
MR. ROBERT WAYNE BOULEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
139 HAZARD AVE., BUILDING 2 SUITE 6, ENFIELD, CT 06082-0608
(860) 218-3614
Mailing address
482 TAYLOR RD, ENFIELD, CT 06082-4047
(413) 250-4144
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/11/2021
Last updated
08/03/2023
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