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General NPI Number Information
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NPI Number | 1184511610
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Entity Type | Individual
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Provider Name | MICHELLE BOSSE MS
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Gender | Female
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Dates
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Enumeration Date | 06/18/2025
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 280 FOREST PARK CIR
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City | PANAMA CITY
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State | FL
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Zip | 32405-4919
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Country | US
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Telephone | 850-964-6429
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Fax |
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Provider Business Mailing Address
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Address Line | 2638 PRETTY BAYOU ISLAND DR
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City | PANAMA CITY
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State | FL
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Zip | 32405-2129
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Country | US
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Telephone | 850-373-7467
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 27555
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License Number State |
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