Individual
EVERETT BOSTICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
702 FRUIT AVE NW APT B, ALBUQUERQUE, NM 87102-2083
(907) 280-8098
Mailing address
10511 GOLF COURSE RD NW STE 103, ALBUQUERQUE, NM 87114-5917
(505) 856-6880
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/14/2025
Last updated
03/14/2025
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