Individual
AMANDA BOSLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPSS
Contact information
Practice address
7232 JUSTIN WAY, MENTOR, OH 44060-4881
(440) 578-8200
Mailing address
7232 JUSTIN WAY, MENTOR, OH 44060-4881
(440) 578-8200
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
0001348
OH
175T00000X
Peer Specialist
Primary
0001348
OH
251B00000X
Case Management Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0365239
—
OH
Enumeration date
07/29/2019
Last updated
04/07/2021
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