NPI | 1003255274 |
---|---|
Former Name | CHELSEA R BOSKA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CT 3515) |
Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301015521) |
Enumeration Date | 2013-06-20 |
Last Update Date | 2016-04-01 |