Individual
THELMA BOULOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.S
Contact information
Practice address
716 E 4500 S STE N160, MURRAY, UT 84107-3617
(801) 281-1100
Mailing address
716 E 4500 S STE N160, MURRAY, UT 84107-3617
(801) 281-1100
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/19/2022
Last updated
08/19/2022
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