Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225C00000X | Rehabilitation Counselor |
NPI | 1013194653 |
---|---|
Provider Name | David Lee Boos |
First Address | Chico, CA 95926-2282 |
Second Address | Chico, CA 95926-2282 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2008 |
Last Update Date | 17/12/2020 |