Individual
SERI BOSSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS
Contact information
Practice address
1506 KANAWHA BLVD W, CHARLESTON, WV 25387-2533
(304) 444-9584
Mailing address
PO BOX 10235, CHARLESTON, WV 25357-0235
(304) 444-9584
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/23/2020
Last updated
11/04/2021
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