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Individual

TERESA ANN BOSHEARS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
18718 MIDDLETOWN RD, PARKTON, MD 21120-9088
(443) 889-9586
Mailing address
18718 MIDDLETOWN RD, PARKTON, MD 21120-9088
(443) 889-9586

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
99103120A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1881848448
SCC NPI
IN
05
200929150A
IN
01
26-3532969
SCC TAX ID
IN
01
261QM0801X
SCC TAXONOMY
IN
Enumeration date
07/14/2021
Last updated
07/27/2021
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