Provider Demographics
NPI:1922357474
Name:BOSSE, MICHELE LYN
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:LYN
Last Name:BOSSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 FAWN LN
Mailing Address - Street 2:
Mailing Address - City:GREENE
Mailing Address - State:ME
Mailing Address - Zip Code:04236-3119
Mailing Address - Country:US
Mailing Address - Phone:207-754-5317
Mailing Address - Fax:
Practice Address - Street 1:971 GARDINER RD
Practice Address - Street 2:
Practice Address - City:WALES
Practice Address - State:ME
Practice Address - Zip Code:04280-3261
Practice Address - Country:US
Practice Address - Phone:207-375-4273
Practice Address - Fax:207-375-2522
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant