Healthcare Provider Details
I. General information
NPI: 1457463408
Provider Name (Legal Business Name): RHONA MELODY BOSIN LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
751 TWINBROOK PKWY THRESHOLD SERVICES
ROCKVILLE MD
20851-1400
US
IV. Provider business mailing address
1111 UNIVERSITY BLVD W 1002
SILVER SPRING MD
20902-3351
US
V. Phone/Fax
- Phone: 301-838-4100
- Fax: 301-315-8331
- Phone: 301-681-4562
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 11572 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: