Provider Demographics
NPI:1265962278
Name:BOLES, RACHEL ANN
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:ANN
Last Name:BOLES
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 1:451 SCOGGINS CREEK TRL
Mailing Address - Street 2:
Mailing Address - City:HARTFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23071-9753
Mailing Address - Country:US
Mailing Address - Phone:804-384-6290
Mailing Address - Fax:
Practice Address - Street 1:451 SCOGGINS CREEK TRL
Practice Address - Street 2:
Practice Address - City:HARTFIELD
Practice Address - State:VA
Practice Address - Zip Code:23071-9753
Practice Address - Country:US
Practice Address - Phone:804-384-6290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician