Individual
BOHYUN PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
850 N HARRISON ST, ATTN: ANNE LAWSON, WARSAW, IN 46580-3163
(574) 267-7169
(574) 268-2377
Mailing address
2621 E JEFFERSON ST, ATTN: ANNE LAWSON, WARSAW, IN 46580-3880
(574) 267-7169
(574) 269-4189
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34007706A
IN
Other
Enumeration date
09/01/2010
Last updated
01/16/2017
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