Individual
JENNIFER BOSWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
290 BRANDYWINE BLVD, FAYETTEVILLE, GA 30214-1560
(770) 460-0165
Mailing address
290 BRANDYWINE BLVD, FAYETTEVILLE, GA 30214-1560
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT007880
GA
Other
Enumeration date
10/08/2020
Last updated
10/08/2020
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