Provider Demographics
NPI:1760782924
Name:BOSTON, CHELINE
Entity Type:Individual
Prefix:
First Name:CHELINE
Middle Name:
Last Name:BOSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20114 CHAD ARBOR TRL
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-5787
Mailing Address - Country:US
Mailing Address - Phone:281-256-0208
Mailing Address - Fax:
Practice Address - Street 1:2611 FM 1960 RD W
Practice Address - Street 2:SUITE H121
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77068-3731
Practice Address - Country:US
Practice Address - Phone:281-377-0770
Practice Address - Fax:281-377-0775
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-21
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16479235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist