Provider Demographics
NPI:1346743846
Name:BOULES, IRINY
Entity Type:Individual
Prefix:
First Name:IRINY
Middle Name:
Last Name:BOULES
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 1:7999 N FEDERAL HWY STE 202
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-1673
Mailing Address - Country:US
Mailing Address - Phone:904-333-2955
Mailing Address - Fax:
Practice Address - Street 1:7999 N FEDERAL HWY STE 202
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-1673
Practice Address - Country:US
Practice Address - Phone:904-333-2955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-12
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health