KENYATTA TAVARIS BOSTIC

SIMPSONVILLE, SC
NPI1447442447
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor Mental Health
Enumeration Date2007-08-14
Last Update Date2007-08-14
Business Address
KENYATTA TAVARIS BOSTIC
20 POWDERHORN RD
SIMPSONVILLE, SC 29681-3399
Phone number: 864-963-3421
Mailing Address
KENYATTA TAVARIS BOSTIC
20 POWDERHORN RD
SIMPSONVILLE, SC 29681-3399
Phone number: 864-963-3421
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