Individual
BRANDON BOLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
2121 SWEET GUM DR, ANNA, TX 75409-0117
(940) 395-9591
Mailing address
325 PATE WAY, ANNA, TX 75409
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
214458
TX
Other
Enumeration date
02/18/2022
Last updated
02/18/2022
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