Doctor Name: | BARBARA LEE BOESL |
NPI Number: | 1427394139 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 644-9-15-09 |
Business Practice Address: | 209 10th Ave Langdon, ND - 582492436 |
Business Phone Number: | 7012562354 |
Business Fax Number: | 7012562358 |
Mailing Address: | 5201 Bishops Blvd S, FARGO |
State: | ND |
Postal Code: | 581047608 |
Phone Number: | 7012354457 |
Fax Number: | 7013567993 |
NPI Enumeration Date: | 12/27/2012 |
NPI Last Update Date: | 12/27/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 644-9-15-09 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ND |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |