Individual
MR. BRANT ANDREW BOLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDCA
Contact information
Practice address
1319 FLORENCEDALE AVE, YOUNGSTOWN, OH 44505-2719
(330) 553-4545
Mailing address
251 N BEVERLY AVE, YOUNGSTOWN, OH 44515-2827
(330) 553-4545
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
169193
OH
Other
Enumeration date
01/09/2019
Last updated
01/09/2019
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