Individual
DERIC J BOSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
110 IOWA LANE, SUITE 202, CARY, NC 27511
(919) 619-1032
(919) 465-2307
Mailing address
110 IOWA LANE, SUITE 202, CARY, NC 27511
(919) 619-1032
(919) 465-2307
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C006078
NC
Other
Enumeration date
01/29/2009
Last updated
01/29/2009
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