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Individual
TRACY BOSANKO
Active
Individual
TRACY BOSANKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
4704329968
MI
Other
Enumeration date
10/21/2024
Last updated
06/06/2025
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