Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst | 1-11-8047 | OH |
NPI | 1013358662 |
---|---|
Provider Name | Jaclynn Bosley |
First Address | Warrensville Heights, OH 44128-6411 |
Second Address | Warrensville Heights, OH 44128-6411 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2013 |
Last Update Date | 01/10/2020 |