Doctor Name: | STEPHANIE CHERYL BOSH |
NPI Number: | 1003275678 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, MCAP |
License Number: | ADC-010765-2015 |
Business Practice Address: | 580 Ellis Rd S Jacksonville, FL - 322543582 |
Business Phone Number: | 9044230017 |
Business Fax Number: | |
Mailing Address: | 580 Ellis Rd S, JACKSONVILLE |
State: | FL |
Postal Code: | 322543582 |
Phone Number: | 9044230017 |
Fax Number: | |
NPI Enumeration Date: | 02/11/2016 |
NPI Last Update Date: | 02/11/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | ADC-010765-2015 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |