Justin Lee Boulware
NPI #1043054000 in Yankton, South Dakota
Provider Information
- NPI Number
- 1043054000
- Entity Type
- Individual
- Name
- Justin Lee Boulware
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Counselor - Mental Health
- Enumeration Date
- Jun 24, 2024
- Last Updated
- Jun 24, 2024
Practice Location
- Address
- 1028 WALNUT ST
- City
- Yankton
- State
- South Dakota
- ZIP Code
- 57078-2910
- Phone
- (605) 665-4606
Specialties & Taxonomy Codes
| Specialty |
|---|
| Counselor - Mental Health — Mental Health |
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