Provider Demographics
NPI:1760141659
Name:BOSSE, NICOLE KARENA (BCBA, MA)
Entity Type:Individual
Prefix:MISS
First Name:NICOLE
Middle Name:KARENA
Last Name:BOSSE
Suffix:
Gender:F
Credentials:BCBA, MA
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Mailing Address - Street 1:49 COLONIAL CIR UNIT D
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-1950
Mailing Address - Country:US
Mailing Address - Phone:860-301-7643
Mailing Address - Fax:
Practice Address - Street 1:116 PLEASANT ST STE 368
Practice Address - Street 2:
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-2759
Practice Address - Country:US
Practice Address - Phone:413-779-4023
Practice Address - Fax:413-517-0379
Is Sole Proprietor?:No
Enumeration Date:2021-12-08
Last Update Date:2021-12-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst