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General NPI Number Information
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NPI Number | 1033756895
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Entity Type | Individual
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Provider Name | KEVIN BOSIN
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Gender | Male
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Dates
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Enumeration Date | 11/28/2019
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Last Update Date | 11/28/2023
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Provider Practice Location Address
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Address Line | 5267 GREENWICH RD
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City | VIRGINIA BEACH
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State | VA
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Zip | 23462-6028
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Country | US
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Telephone | 757-529-0484
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Fax |
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Provider Business Mailing Address
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Address Line | 2008 SUNSET MAPLE LN
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City | CHESAPEAKE
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State | VA
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Zip | 23323-6359
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904011379
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License Number State | VA
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