| Janice Wunderle Bosley Phd Llc | |
|
4775 Knightsbridge Blvd Suite 203 Columbus OH 43214-4313 | |
| (740) 881-4394 | |
| (740) 881-1515 |
| Full Name | Janice Wunderle Bosley Phd Llc |
|---|---|
| Speciality | Psychologist |
| Location | 4775 Knightsbridge Blvd, Columbus, Ohio |
| Authorized Official Name and Position | Janice Wunderle Bosley (OWNER) |
| Authorized Official Contact | 7408814394 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Janice Wunderle Bosley Phd Llc 5295 Baypointe Dr Powell OH 43065-9042 Ph: (740) 881-4394 | Janice Wunderle Bosley Phd Llc 4775 Knightsbridge Blvd Suite 203 Columbus OH 43214-4313 Ph: (740) 881-4394 |
| NPI Number | 1104133289 |
|---|---|
| Provider Enumeration Date | 09/09/2010 |
| Last Update Date | 09/09/2010 |
| Medicare PECOS PAC ID | 0840315701 |
|---|---|
| Medicare Enrollment ID | O20100915000683 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104133289 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TR0400X | Psychologist - Rehabilitation | 3738 (Ohio) | Primary |
| Provider Name | Janice W Bosley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316049992 PECOS PAC ID: 4789709650 Enrollment ID: I20100915000801 |
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