Provider Demographics
NPI:1720863897
Name:BOSS, DELANEY (PHD)
Entity type:Individual
Prefix:
First Name:DELANEY
Middle Name:
Last Name:BOSS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2139 MARYLAND CIR STE 1200
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-1001
Mailing Address - Country:US
Mailing Address - Phone:850-644-2222
Mailing Address - Fax:
Practice Address - Street 1:2139 MARYLAND CIR STE 1200
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32303-1001
Practice Address - Country:US
Practice Address - Phone:850-644-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-28
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11953103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist