Provider Demographics
NPI:1164588810
Name:SOLLARS-BOSLEY, MICHELLE ANN
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:ANN
Last Name:SOLLARS-BOSLEY
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 1:1822 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HIGGINSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64037-1525
Mailing Address - Country:US
Mailing Address - Phone:660-909-6688
Mailing Address - Fax:660-584-5455
Practice Address - Street 1:1822 MAIN ST
Practice Address - Street 2:
Practice Address - City:HIGGINSVILLE
Practice Address - State:MO
Practice Address - Zip Code:64037-1525
Practice Address - Country:US
Practice Address - Phone:660-584-5333
Practice Address - Fax:660-584-5455
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities