Individual
LATONYA BOULWARE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSW, MBA
Contact information
Practice address
2289 SPENCER BOYD RD, GREAT FALLS, SC 29055-8908
(803) 482-6754
Mailing address
2289 SPENCER BOYD RD, GREAT FALLS, SC 29055-8908
(803) 482-6754
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
251B00000X
Case Management Agency
—
—
Other
Enumeration date
09/21/2019
Last updated
09/21/2019
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