Boulware, Sandra Sue Dale

Boulware, Sandra Sue Dale is an sole proprietor health care provider with primary practice located at 1121 K St Nw , Miami OK 74354-2915. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / School. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Boulware, Sandra Sue Dale can be contacted via phone (918) 542-5671.

Contact Information

Primary practice address
1121 K St Nw Miami OK 74354-2915
Phone: (918) 542-5671
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X 440 Oklahoma
Behavioral Health & Social Service Providers / Professional 101YP2500X 15991 Oklahoma
Behavioral Health & Social Service Providers / Professional 101YP2500X 440 Oklahoma
Behavioral Health & Social Service Providers / School 101YS0200X 109413 Oklahoma

Profile Details

NPI number 1235373465
LBN Legal business name Boulware, Sandra Sue Dale
Credentials LPC, MAC
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 1st, 2009
Last updated May 1st, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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