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General NPI Number Information
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NPI Number | 1619712577
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Entity Type | Individual
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Provider Name | ANNAMARIE BOITS EDS, NCSP
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Gender | Female
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Dates
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Enumeration Date | 07/01/2024
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Last Update Date | 07/01/2024
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Provider Practice Location Address
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Address Line | 611 BERKLEY ST
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City | PLYMOUTH
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State | IN
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Zip | 46563-1817
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Country | US
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Telephone | 574-936-3115
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Fax |
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Provider Business Mailing Address
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Address Line | 3233 S 925 E
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City | NORTH LIBERTY
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State | IN
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Zip | 46554-9512
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 10212178
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License Number State | IN
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