Provider Demographics
NPI:1053537134
Name:MISIASZEK-BOSER, JO ANN M (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JO ANN
Middle Name:M
Last Name:MISIASZEK-BOSER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29703 MORNINGMIST DR
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-6741
Mailing Address - Country:US
Mailing Address - Phone:813-310-3295
Mailing Address - Fax:
Practice Address - Street 1:29703 MORNINGMIST DR
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-6741
Practice Address - Country:US
Practice Address - Phone:813-310-3295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW60651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical