| Doctor Name: | MICHELLE LOUISE BOSCO |
| NPI Number: | 1003031519 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | L.M.S.W. |
| License Number: | 073341-1 |
| Business Practice Address: | 14 Slosson Ter Staten Island, NY - 103012507 |
| Business Phone Number: | 7187206727 |
| Business Fax Number: | 7187200326 |
| Mailing Address: | 278 Ashworth Ave, STATEN ISLAND |
| State: | NY |
| Postal Code: | 103144912 |
| Phone Number: | 7184943341 |
| Fax Number: | |
| NPI Enumeration Date: | 04/17/2007 |
| NPI Last Update Date: | 04/22/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 073341-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |