Organization
HALEIGH BOUSLOG LMHC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HALEIGH BOUSLOG (LMHC, OWNER)
(605) 359-1840
Entity
Organization
Contact information
Practice address
12345 UNIVERSITY AVE STE 310, CLIVE, IA 50325-8285
(515) 329-0213
Mailing address
12345 UNIVERSITY AVE STE 310, CLIVE, IA 50325-8285
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/18/2025
Last updated
06/18/2025
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