Doctor Name: | CYNTHIA BOSS |
NPI Number: | 1487025573 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 6401003896 |
Business Practice Address: | 1404 Bridge St Charlevoix, MI - 497202603 |
Business Phone Number: | 2316750994 |
Business Fax Number: | |
Mailing Address: | Po Box 611, CHARLEVOIX |
State: | MI |
Postal Code: | 497200611 |
Phone Number: | 2316750994 |
Fax Number: | |
NPI Enumeration Date: | 10/14/2015 |
NPI Last Update Date: | 10/14/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 6401003896 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |