MEDICARE: ALISON BOZIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst
2	171M00000X	Case Manager/Care Coordinator
3	101YM0800X	Mental Health Counselor	LH60840473	WA

General Provider Information

NPI Number	:	1154697977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALISON BOZIC

Provider Business Mailing Address
First Line	:	1202 S WASHINGTON ST
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98405-2059
Country	:	US
Telephone Number	:	253-310-1647
Fax Number	:

Provider Business Practice Location Address
First Line	:	1202 S WASHINGTON ST
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98405-2059
Country	:	US
Telephone Number	:	253-310-1647
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2012
Last Update Date	:	01/18/2019

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