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Individual

MELISSA A BOSHANS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.ED.

Contact information

Practice address
2627 N RIDGEWAY AVE, 3N, CHICAGO, IL 60647-1119
(773) 876-4090
Mailing address
2627 N RIDGEWAY AVE, 3N, CHICAGO, IL 60647-1119
(773) 876-4090

Taxonomy

Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary

Other

Enumeration date
08/15/2012
Last updated
08/15/2012
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