Doctor Name: | KELLY ANN BOSAK |
NPI Number: | 1558702779 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, CCC-SLP |
License Number: | SL010992 |
Business Practice Address: | 312 North Washington Avenue Scranton, PA - 18503 |
Business Phone Number: | 5703431950 |
Business Fax Number: | 5703431951 |
Mailing Address: | 716a Parrott Avenue, SCRANTON |
State: | PA |
Postal Code: | 18504 |
Phone Number: | 8145716658 |
Fax Number: | |
NPI Enumeration Date: | 07/16/2013 |
NPI Last Update Date: | 07/16/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SL010992 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |