Individual
MR. ARVIS BENNETT BOUGHMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MACCCSLP
Contact information
Practice address
202 MIMOSA DRIVE, DREXEL, NC 28619-2795
(828) 443-4395
Mailing address
PO BOX 2795, 202 MIMOSA DRIVE, DREXEL, NC 28619-2795
(828) 443-4395
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP 4704
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7411307
—
NC
Enumeration date
01/04/2007
Last updated
07/09/2007
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