person
Mrs. Illene Rita Bosley, MS,CAC-I
Addiction (Substance Use Disorder) Counselor in Highland Park, Michigan
NPI 1225156177

Illene Rita Bosley is an Addiction (Substance Use Disorder) Counselor based in Detroit, MI and is specialized in Addiction (Substance Use Disorder). Illene Rita Bosley practices in Highland Park, MI and has the professional credentials of MS,CAC-I. The NPI Number for Illene Rita Bosley is 1225156177 and holds a License No. 104259 (Michigan).

The current practice location address for Illene Rita Bosley is 13220 Woodward Ave, Highland Park, MI and can be reached out via phone at 313-868-1946.

Location: 13220 Woodward Ave, Highland Park, MI, 48201-2410
person
Provider Profile Details
NPI Number
1225156177
Provider Name
Illene Rita Bosley
Credential
MS,CAC-I
Provider Entity Type
Individual
Gender
Female
Address
13220 Woodward Ave, Highland Park, MI, 48201-2410
Phone Number
313-868-1946
Fax Number
Provider Enumeration Date
03/27/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1063545556 01 MI GENESIS HOUSE III
1740313238 01 MI CHRISTIAN GUIDANCE CENTER
3022440 05 MI
institution
Provider Business Practice Location Address Details
Address
13220 Woodward Ave
City
State
Zip
48203-3610
Phone Number
313-868-1946
Fax Number
person
Provider Business Mailing Address Details
Address
13220 Woodward Ave
City
State
Zip
48203-3610
Phone Number
313-868-1946
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
104259 (Michigan)
Definition
Definition to come...
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