Provider Demographics
NPI:1437506466
Name:BOSCO, AMY (MS, LGC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:BOSCO
Suffix:
Gender:F
Credentials:MS, LGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:472 TUCKER HILL RD
Mailing Address - Street 2:
Mailing Address - City:THETFORD CENTER
Mailing Address - State:VT
Mailing Address - Zip Code:05075-8928
Mailing Address - Country:US
Mailing Address - Phone:603-653-6025
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:DARTMOUTH HITCHCOCK MEDICAL CENTER
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-1000
Practice Address - Country:US
Practice Address - Phone:603-653-6025
Practice Address - Fax:603-653-3545
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-19
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS