Bosworth, Theresa Marie

Bosworth, Theresa Marie is an sole proprietor health care provider with primary practice located at 1425 Michigan Ne Suite A , Grand Rapids MI 49503. She recently has only one registered license in Speech, Language and Hearing Service Providers / Audiologist, which is considered as her primary health care specialty. Bosworth, Theresa Marie can be contacted via phone (616) 459-4514.

Contact Information

Primary practice address
1425 Michigan Ne Suite A Grand Rapids MI 49503
Fax: (616) 459-5001
Website:

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist 231H00000X 1601000098 Michigan

Profile Details

NPI number 1932329729
LBN Legal business name Bosworth, Theresa Marie
Credentials MA,CCC-A
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 26th, 2007
Last updated Aug 19th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932329729 NPPES
Michigan Other 640D126260 BLUE SHIELD HEARING PROVI

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