Provider Demographics
NPI:1225788128
Name:BOSAH, DEBORAH IFEOMA (CNA, HHA)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:IFEOMA
Last Name:BOSAH
Suffix:
Gender:F
Credentials:CNA, HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:946 BAY RD # 2
Mailing Address - Street 2:
Mailing Address - City:SOUTH HAMILTON
Mailing Address - State:MA
Mailing Address - Zip Code:01982-1105
Mailing Address - Country:US
Mailing Address - Phone:978-605-3891
Mailing Address - Fax:
Practice Address - Street 1:946 BAY RD # 2
Practice Address - Street 2:
Practice Address - City:SOUTH HAMILTON
Practice Address - State:MA
Practice Address - Zip Code:01982-1105
Practice Address - Country:US
Practice Address - Phone:978-605-3891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NA104100000X
104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherNA