Individual
JANINE RENE BOULDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
8445 MUNSON RD, MENTOR, OH 44060-2410
(440) 255-1700
Mailing address
443 HIGH ST UNIT 2, FAIRPORT HARBOR, OH 44077-5830
(440) 477-7191
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
Primary
S.2208539
OH
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
09/20/2021
Last updated
12/07/2022
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