Individual
ALYCIA ANN BOSCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
2951 S 34TH ST, GRAND FORKS, ND 58201
(701) 772-3851
Mailing address
2200 LIBRARY CIRCLE, GRAND FORKS, ND 58201
(701) 757-2155
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1878
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1483616
—
ND
Enumeration date
08/30/2021
Last updated
07/22/2022
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