Individual
SUZANNE MARIE BOSEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, TLLP
Contact information
Practice address
39319 PLYMOUTH RD, LIVONIA, MI 48150-1059
(248) 259-1991
(248) 286-6062
Mailing address
39319 PLYMOUTH RD, LIVONIA, MI 48150-1059
(248) 259-1991
(248) 286-6062
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301018165
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6301018165
STATE LICENSE NUMBER
MI
Enumeration date
09/29/2019
Last updated
09/29/2019
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