Individual
JACKIE BOSTICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
8111 CRESTVIEW DR SE, COVINGTON, GA 30014-3263
(678) 787-9339
Mailing address
PO BOX 2384, COVINGTON, GA 30015-7384
(678) 787-9339
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
—
—
Other
Enumeration date
02/21/2024
Last updated
02/29/2024
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