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Individual

MR. THOMAS MATTHEW BOSWORTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSW

Contact information

Practice address
420 QUINCY ST, RAPID CITY, SD 57701-3626
(605) 343-7755
(605) 716-0650
Mailing address
420 QUINCY ST # 215, RAPID CITY, SD 57701-3626
(605) 343-7755
(605) 721-8896

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1590
SD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6570593
SD
Enumeration date
12/11/2006
Last updated
04/05/2020
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