SANDRA SUE DALE BOULWARE

MIAMI, OK
NPI1235373465
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YP2500X Counselor Professional
(Licence: OK  440)
Additional Taxonomies101Y00000X Counselor
(Licence: OK  440)
101YP2500X Counselor Professional
(Licence: OK  15991)
101YS0200X Counselor School
(Licence: OK  109413)
Enumeration Date2009-05-01
Last Update Date2009-05-01
Business Address
MS. SANDRA SUE DALE BOULWARE LPC, MAC
1121 K ST NW
MIAMI, OK 74354-2915
Phone number: 918-542-5671
Mailing Address
MS. SANDRA SUE DALE BOULWARE LPC, MAC
1121 K ST NW
MIAMI, OK 74354-2915
Phone number: 918-542-5671