Individual
AUTUMN BOSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2510 WASHINGTON ST, MANITOWOC, WI 54220-4858
(920) 629-6126
Mailing address
2510 WASHINGTON ST, MANITOWOC, WI 54220-4858
(920) 629-6126
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/23/2024
Last updated
07/23/2024
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