MEDICARE: MRS. ANGELA CHAMPAGNE BOSWELL LMSW

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	104100000X	Social Worker

General Provider Information

NPI Number	:	1932890134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANGELA CHAMPAGNE BOSWELL LMSW

Provider Business Mailing Address
First Line	:	319 EAST TUMBLEWEED DRIVE
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85085
Country	:	US
Telephone Number	:	310-796-6577
Fax Number	:

Provider Business Practice Location Address
First Line	:	AZ HOLISTIC APPROACH
Second Line	:	3240 E. UNION HILLS DR. #107
City	:	PHOENIX
State	:	AZ
Zip	:	85050
Country	:	US
Telephone Number	:	310-796-6577
Fax Number	:

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

Provider Enumeration Date	:	05/17/2023
Last Update Date	:	05/05/2026

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