Individual
MR. BRIAN KEITH BOLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
WYOMING LPC 1705
Contact information
Practice address
1430 WILKINS CIR, CASPER, WY 82601-1336
(307) 237-9583
(307) 265-7277
Mailing address
1430 WILKINS CIR, CASPER, WY 82601-1336
(307) 237-9583
(307) 265-7277
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1705
WY
Other
Enumeration date
09/24/2015
Last updated
01/05/2018
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