Provider Demographics
NPI:1972508844
Name:BOER, ANTHONY L (MSW)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:L
Last Name:BOER
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:TONY
Other - Middle Name:L
Other - Last Name:BOER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSWW
Mailing Address - Street 1:2000 S SYCAMORE AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57110-4263
Mailing Address - Country:US
Mailing Address - Phone:605-271-0261
Mailing Address - Fax:605-271-0263
Practice Address - Street 1:2000 S SYCAMORE AVE
Practice Address - Street 2:STE 101
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57110-4263
Practice Address - Country:US
Practice Address - Phone:605-271-0261
Practice Address - Fax:605-271-0263
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD18651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical