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General NPI Number Information
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NPI Number | 1679801278
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Entity Type | Individual
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Provider Name | DOROTHY L BOSTON PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 11/20/2009
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Last Update Date | 11/12/2020
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Provider Practice Location Address
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Address Line | 15167 HUNTINGTON RD
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City | GALLIPOLIS FERRY
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State | WV
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Zip | 25515-6615
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Country | US
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Telephone | 304-675-5725
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Fax | 304-675-5727
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Provider Business Mailing Address
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Address Line | 2585 3RD AVE
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City | HUNTINGTON
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State | WV
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Zip | 25703-1642
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Country | US
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Telephone | 304-697-1396
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Fax | 304-697-2086
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 6843
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 749
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License Number State | WV
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