Organization
BOOSHKE MENTAL HEALTH INC.
Active
Organization
BOOSHKE MENTAL HEALTH INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MELISSA ANN GEORGE-HUMPHREY LICSW (MENTAL HEALTH PROFESSIONAL)
(218) 760-2222
Entity
Organization
Contact information
Practice address
522 BELTRAMI AVE NW STE 116, BEMIDJI, MN 56601-3002
(218) 760-2222
(218) 444-7105
Mailing address
2201 SHANNON LN SE, BEMIDJI, MN 56601-7328
(218) 760-2222
(218) 444-7105
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
14486
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
288620100
—
MN
Enumeration date
05/17/2006
Last updated
05/11/2011
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