Individual
LEIGH BOSTIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
110 MANLY ST, GREENVILLE, SC 29601-3025
(864) 298-8026
(864) 298-8032
Mailing address
110 MANLY ST, GREENVILLE, SC 29601-3025
(864) 298-8026
(864) 298-8032
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5459
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q49921E638
MEDICARE PTAN
SC
05
—
SW1013
—
SC
Enumeration date
02/07/2007
Last updated
04/21/2016
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