Individual
MRS. EVELYN BOSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
120 S FIFTH ST, GRAND HAVEN, MI 49417
(616) 842-9198
Mailing address
120 S FIFTH ST, GRAND HAVEN, MI 49417
(616) 842-9198
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801032838
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8008976750
BLUE CROSS PIN
MI
Enumeration date
03/26/2008
Last updated
03/26/2008
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