Doctor Name: | ELIZABETH MICHELLE BOSTIC |
NPI Number: | 1013092345 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 0904002039 |
Business Practice Address: | 1611 Old Mayfield Rd Danville, VA - 245417511 |
Business Phone Number: | 4347993318 |
Business Fax Number: | 4347993318 |
Mailing Address: | 1611 Old Mayfield Rd, DANVILLE |
State: | VA |
Postal Code: | 245417511 |
Phone Number: | 4347993318 |
Fax Number: | 4347993318 |
NPI Enumeration Date: | 10/26/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 0904002039 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |