Individual
MR. RICHARD L BOSSARDT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.C.S.W.
Contact information
Practice address
2085 THOMPSON RD, COOS BAY, OR 97420-2085
(541) 269-5333
(541) 269-5609
Mailing address
2085 THOMPSON RD, COOS BAY, OR 97420-2085
(541) 269-5333
(541) 269-5609
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
350194
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35 0194
CLINICAL SOCIAL WORKERS
OR
Enumeration date
09/15/2006
Last updated
07/28/2010
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