Individual
ROBERT JOHN BOULEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, LPCC
Contact information
Practice address
7300 147TH ST W STE 204, APPLE VALLEY, MN 55124-7850
(952) 997-3020
(952) 997-3026
Mailing address
1900 SILVER LAKE RD NW STE 110, NEW BRIGHTON, MN 55112-1789
(651) 628-9566
(651) 628-0411
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CC00576
MN
Other
Enumeration date
04/17/2013
Last updated
12/31/2018
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