Provider Demographics
NPI:1770623639
Name:BOSSIO, DEBRA ANN (ND)
Entity type:Individual
Prefix:DR
First Name:DEBRA
Middle Name:ANN
Last Name:BOSSIO
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 DANBURY RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-4107
Mailing Address - Country:US
Mailing Address - Phone:203-431-4443
Mailing Address - Fax:203-431-6664
Practice Address - Street 1:100 DANBURY RD
Practice Address - Street 2:SUITE 102
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-4107
Practice Address - Country:US
Practice Address - Phone:203-431-4443
Practice Address - Fax:203-431-6664
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1511175F00000X
CT000395175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath