Individual
ILYSSA LYNN BOSESKI
Active
Individual
ILYSSA LYNN BOSESKI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, MSW, MED
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
Q1-0011815
DE
1041C0700X
Clinical Social Worker
SW134698
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q1-0011815
DIVISION OF PROFESSIONAL REGULATION
DE
01
—
SW134698
PENNSYLVANIA LICENSING SYSTEM
PA
Enumeration date
11/21/2017
Last updated
08/19/2022
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