Provider Demographics
NPI:1285086777
Name:BOLER, TONI
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:
Last Name:BOLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2809 ARKANSAS RD LOT 6
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-8677
Mailing Address - Country:US
Mailing Address - Phone:318-381-6436
Mailing Address - Fax:
Practice Address - Street 1:2809 ARKANSAS RD
Practice Address - Street 2:#6
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-8694
Practice Address - Country:US
Practice Address - Phone:318-381-0643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-07
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor