| Doctor Name: | MISS NICOLE BOSTON |
| NPI Number: | 1063899748 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC, MA, MHS |
| License Number: | PC008130 |
| Business Practice Address: | 31 Peartree Ln Willingboro, NJ - 080462709 |
| Business Phone Number: | 2674564765 |
| Business Fax Number: | |
| Mailing Address: | 31 Peartree Ln, WILLINGBORO |
| State: | NJ |
| Postal Code: | 080462709 |
| Phone Number: | 2674564765 |
| Fax Number: | |
| NPI Enumeration Date: | 05/01/2015 |
| NPI Last Update Date: | 05/23/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | PC008130 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |