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NPI Code Detail

MEDICARE: SUZANNE MARIE BOSS LPC

MEDICARE: SUZANNE MARIE BOSS LPC
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
1101YP2500XProfessional Counselor2006033518MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22006033518OTHERMOPROVISIONAL LICENSE #

General Provider Information

NPI Number : 1457499402
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUZANNE MARIE BOSS LPC
Provider Business Mailing Address
First Line : 1300 E BRADFORD PKWY
Second Line :
City : SPRINGFIELD
State : MO
Zip : 65804-4264
Country : US
Telephone Number : 417-761-5000
Fax Number : 417-761-5111
Provider Business Practice Location Address
First Line : 7115 E SAINT CHARLES RD
Second Line :
City : COLUMBIA
State : MO
Zip : 65202-0196
Country : US
Telephone Number : 573-884-6851
Fax Number : 573-884-0293
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2007
Last Update Date : 03/07/2023

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Directions to “ SUZANNE MARIE BOSS LPC” Practice Location

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