Provider Demographics
NPI:1447499272
Name:BOSCARO, LAURIE ANN
Entity type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:ANN
Last Name:BOSCARO
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 1:603 N 8TH ST
Mailing Address - Street 2:
Mailing Address - City:GUNNISON
Mailing Address - State:CO
Mailing Address - Zip Code:81230-3547
Mailing Address - Country:US
Mailing Address - Phone:970-901-9192
Mailing Address - Fax:
Practice Address - Street 1:603 N 8TH ST
Practice Address - Street 2:
Practice Address - City:GUNNISON
Practice Address - State:CO
Practice Address - Zip Code:81230-3547
Practice Address - Country:US
Practice Address - Phone:970-901-9192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-18
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker