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General NPI Number Information
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NPI Number | 1851723506
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Entity Type | Individual
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Provider Name | DEBRA LEE BOSS M. ED. LPC
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Gender | Female
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Dates
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Enumeration Date | 08/05/2013
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Last Update Date | 09/14/2015
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Provider Practice Location Address
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Address Line | 4386 BAKER RD
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City | ROFF
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State | OK
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Zip | 74865-9503
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Country | US
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Telephone | 580-713-3571
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Fax | 580-456-7820
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Provider Business Mailing Address
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Address Line | 4386 BAKER RD
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City | ROFF
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State | OK
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Zip | 74865-9503
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Country | US
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Telephone | 580-713-3571
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Fax | 580-456-7820
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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 | 226270
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 5833
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License Number State | OK
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