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Individual

BETHANY BOSWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS CCC-SLP

Contact information

Practice address
930 W CENTERVILLE RD, GARLAND, TX 75041-5823
(972) 303-7021
Mailing address
6524 SAINT MORITZ AVE, DALLAS, TX 75214-2428
(214) 364-0225

Taxonomy

Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
34989
TX
235Z00000X
Speech-Language Pathologist
Primary
107967
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
149984001
TX
Enumeration date
08/23/2010
Last updated
12/17/2014
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