Individual
JESSICA BOSAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
705 12TH ST, ALTOONA, PA 16602-2419
(814) 944-9970
Mailing address
1310 VALLEY VIEW BLVD, ALTOONA, PA 16602-6080
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
SW133053
PA
Other
Enumeration date
08/16/2018
Last updated
08/16/2018
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