Makayla Bosch
Social Worker, Clinical in Danville, IL. Individual provider (NPI-1).
NPI number1598064800
StatusActive
Last updated in NPPESJul 21, 2016
Details
- NPI
- 1598064800
- Entity type
- Individual (NPI-1)
- Name
- Makayla Bosch
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 25, 2011
- Last updated
- Jul 21, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 149018661 | IL | Yes |
Practice location
1900 E Main StDanville, IL 61832-5100
Phone 217-554-3813
Mailing address
403 S Main StHomer, IL 61849-1319
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