Individual
BRAD THOMAS BOYLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCPC
Contact information
Practice address
520 N PATTEE STREET, MISSOULA, MT 59802
(406) 549-3727
(406) 549-3727
Mailing address
520 N PATTEE STREET, MISSOULA, MT 59802
(406) 549-3727
(406) 549-3727
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1120
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0256295
—
MT
Enumeration date
08/30/2006
Last updated
07/08/2007
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