MEDICARE: MICHELLE BOSSE MS

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	101YM0800X	Mental Health Counselor	27555

General Provider Information

NPI Number	:	1184511610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE BOSSE MS

Provider Business Mailing Address
First Line	:	2638 PRETTY BAYOU ISLAND DR
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-2129
Country	:	US
Telephone Number	:	850-373-7467
Fax Number	:

Provider Business Practice Location Address
First Line	:	280 FOREST PARK CIR
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4919
Country	:	US
Telephone Number	:	850-964-6429
Fax Number	:

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

Provider Enumeration Date	:	06/18/2025
Last Update Date	:	06/18/2025

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Directions to “ MICHELLE BOSSE MS” Practice Location

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