Individual
DIANA M BOSWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MCD, CCC
Contact information
Practice address
4191 WASH LEE CT SW, LILBURN, GA 30047-7440
(770) 935-7613
Mailing address
4191 WASH LEE CT SW, LILBURN, GA 30047-7440
(770) 935-7613
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
005203
GA
Other
Enumeration date
04/02/2012
Last updated
04/02/2012
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