| NPI | 1053822015 |
|---|---|
| Former Name | ROXANN BOSTIC |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH22013) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NJ 37LC00216800) |
| 101YP2500X Counselor Professional (Licence: PA PC009568) | |
| Enumeration Date | 2017-10-18 |
| Last Update Date | 2023-08-07 |