Individual
KAMYSHIA ELIZABETH BOSTICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
624 NW 5TH ST, MOORE, OK 73160-3924
(405) 799-3379
Mailing address
624 NW 5TH ST, MOORE, OK 73160-3924
(405) 403-2371
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8056
OK
Other
Enumeration date
02/11/2025
Last updated
02/13/2025
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