Individual
ELLIOTT JAMES BOSAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
427 WEST TRAVELERS TRAIL, BURNSVILLE MN, 55337, 427 WEST TRAVELERS TRAIL, BURNSVILLE MN, 55337, BURNSVILLE, MN 55337
(952) 247-2954
Mailing address
427 WEST TRAVELERS TRAIL, BURNSVILLE MN, 55337, 427 WEST TRAVELERS TRAIL, BURNSVILLE MN, 55337, BURNSVILLE, MN 55337
(952) 247-2954
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/06/2022
Last updated
09/15/2022
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