Individual
JON S BOS
Active
Individual
JON S BOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
1382
SC
103G00000X
Clinical Neuropsychologist
6301010098
MI
103T00000X
Psychologist
202170
AR
103TC0700X
Clinical Psychologist
Primary
1382
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1922123645
NPI
—
01
—
680D116880
BCBS PROVIDER I.D.
MI
Enumeration date
03/20/2007
Last updated
04/24/2025
Update your record
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