Individual
MRS. MARCIE BOSTIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC/SLP
Contact information
Practice address
434 ALDERSON ST, LEWISBURG, WV 24901-2819
(304) 661-1745
Mailing address
434 ALDERSON ST, LEWISBURG, WV 24901-2819
(304) 661-1745
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-0816
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09148046
ASHA CERTIFICATE OF CLINICAL COMPETENCE (AMERICAN SPEECH HEARING ASSOCIATION)
—
05
—
7401147000
—
WV
01
—
SLP-0816
WV BOARD OF EXAMINERS LICENSE FOR SPEECH PATHOLOGISTS AND AUDIOLOGISTS
WV
Enumeration date
09/27/2006
Last updated
08/28/2024
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