Individual
MS. LAREACA NAONE BOSTICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
123 WHEEHAW RD, MACON, GA 31211-7013
(478) 973-8627
Mailing address
123 WHEEHAW RD, MACON, GA 31211-7013
(478) 973-8627
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW008957
GA
246RM2200X
Medical Laboratory Technician
—
—
Other
Enumeration date
06/03/2014
Last updated
02/26/2024
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