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Individual

DIANE BOSL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS LP

Contact information

Practice address
818 2ND ST S, SUITE 180, WAITE PARK, MN 56387-4528
(320) 257-1800
(320) 257-1801
Mailing address
818 2ND STREET SOUTH, SUITE 180 GRANITE CITY COUNSELING, LLC, WAITE PARK, MN 56387
(320) 257-1800
(320) 257-1801

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP 2823
MN
104100000X
Social Worker
7148
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
928250500
MN
Enumeration date
09/27/2006
Last updated
11/24/2010
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