| NPI | 1598387706 | 
|---|---|
| Former Name | CHRISTOPHER W BOYLAN | 
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN cc02166) | 
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH60201099) | 
| Enumeration Date | 2020-05-11 | 
| Last Update Date | 2020-05-13 |