Individual
URSULA DENISE BOSTIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LBSW
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
36369
TX
251B00000X
Case Management Agency
Primary
36369
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159235403
—
TX
05
—
164134202
—
TX
Enumeration date
01/19/2007
Last updated
08/22/2016
Update your record
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