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1134545908
TAVARES BOSTIC
WHITEVILLE, NC
NPI
1134545908
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NC C010090)
Enumeration Date
2014-03-17
Last Update Date
2016-06-23
Business Address
Mr. TAVARES BOSTIC LCSW
102 W MAIN ST SUITE A
WHITEVILLE, NC 28472-4012
Phone number: 910-642-7463
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Mailing Address
Mr. TAVARES BOSTIC LCSW
201 STROMAN RD
MARSTON, NC 28363-9501
Phone number: 585-967-8396
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