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1104247279
TANNER LEE BOLES
MOORE, OK
NPI
1104247279
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: OK LPC06783)
Enumeration Date
2013-12-17
Last Update Date
2023-10-25
Business Address
TANNER LEE BOLES M.A.
620 NW 5TH ST
MOORE, OK 73160-3948
Phone number: 405-208-4469
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Mailing Address
TANNER LEE BOLES M.A.
9124 ROLLING MEADOWS DR
GUTHRIE, OK 73044-8645
Phone number: 405-509-3562
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