Provider Demographics
NPI:1033519038
Name:BOSELLI, KATHLEEN JILL
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:JILL
Last Name:BOSELLI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 KENSINGTON LN
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-6073
Mailing Address - Country:US
Mailing Address - Phone:603-232-0222
Mailing Address - Fax:
Practice Address - Street 1:60 KENSINGTON LN
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6073
Practice Address - Country:US
Practice Address - Phone:603-232-0222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-27
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0232225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist