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1104802230
GINA BOSCO
BURLEY, ID
NPI
1104802230
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: ID LCSW1034)
Enumeration Date
2005-12-20
Last Update Date
2007-07-08
Business Address
-- GINA BOSCO LCSW
2300 OVERLAND AVE
BURLEY, ID 83318-2932
Phone number: 208-732-8565
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Mailing Address
-- GINA BOSCO LCSW
PO BOX 462
BURLEY, ID 83318-0462
Phone number: 208-670-3900
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