Provider Demographics
NPI:1588836829
Name:BOSS, ALIYA SABRIYA (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:ALIYA
Middle Name:SABRIYA
Last Name:BOSS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12340 STOWE ACRES DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28262-1002
Mailing Address - Country:US
Mailing Address - Phone:704-651-9826
Mailing Address - Fax:
Practice Address - Street 1:12340 STOWE ACRES DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28262-1002
Practice Address - Country:US
Practice Address - Phone:704-651-9826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0059751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical