Doctor Name: | SIDNEY RAY BOATLER |
NPI Number: | 1710954334 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC LPA |
License Number: | 14232 |
Business Practice Address: | 2626 S Clack St Abilene, TX - 79605 |
Business Phone Number: | 3256912041 |
Business Fax Number: | |
Mailing Address: | 2626 S Clack St, ABILENE |
State: | TX |
Postal Code: | 79605 |
Phone Number: | 3256912041 |
Fax Number: | 3256912035 |
NPI Enumeration Date: | 03/02/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 14232 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |