Provider Demographics
NPI:1346363355
Name:BOSS, BETH ANN (MA)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:ANN
Last Name:BOSS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16504 MUELLER CIR.
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586
Mailing Address - Country:US
Mailing Address - Phone:815-556-8398
Mailing Address - Fax:
Practice Address - Street 1:16504 MUELLER CIR.
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60586
Practice Address - Country:US
Practice Address - Phone:815-556-8398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist