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1245622836
MARY HANSEN BOAL
EVANSTON, WY
NPI
1245622836
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WY LAT-195)
Enumeration Date
2015-02-19
Last Update Date
2015-02-19
Business Address
Ms. MARY HANSEN BOAL LAT, NCACII, BSW
77 COUNTY RD 109
EVANSTON, WY 82930-2543
Phone number: 307-783-1088
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Mailing Address
Ms. MARY HANSEN BOAL LAT, NCACII, BSW
1013 CHEYENNE DRIVE SUITE A
EVANSTON, WY 82930-2543
Phone number: 307-783-1088
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