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General NPI Number Information
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NPI Number | 1346677283
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Entity Type | Individual
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Provider Name | JOSHUA BOSWELL
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Gender | Male
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Dates
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Enumeration Date | 10/10/2013
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Last Update Date | 08/09/2022
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Provider Practice Location Address
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Address Line | 7490 SUTHERLAND CIRCLE BLDG 7490
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City | FORT CARSON
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State | CO
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Zip | 80913
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Country | US
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Telephone | 706-207-1408
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Fax |
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Provider Business Mailing Address
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Address Line | 7811 BAD TOELZ RD
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City | FORT CARSON
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State | CO
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Zip | 80913-4653
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Country | US
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Telephone | 706-207-1408
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY-004625
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License Number State | AZ
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