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Individual

MR. COREY CHARLES BOLEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MA CCC-SLP

Contact information

Practice address
8124 KNIGHTS CROSSING CT, O FALLON, MO 63368-6225
(636) 346-2219
Mailing address
8124 KNIGHTS CROSSING CT, O FALLON, MO 63368-6225
(636) 346-2219

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2005002432
MO
235Z00000X
Speech-Language Pathologist

Other

Enumeration date
04/20/2007
Last updated
08/28/2023
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