MEDICARE: MACKENZIE OSBORN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist		MA

General Provider Information

NPI Number	:	1568075661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MACKENZIE OSBORN

Provider Business Mailing Address
First Line	:	9 ISABEL CIR
Second Line	:
City	:	LEOMINSTER
State	:	MA
Zip	:	01453-8101
Country	:	US
Telephone Number	:	978-320-0580
Fax Number	:

Provider Business Practice Location Address
First Line	:	165 CRAWFORD ST
Second Line	:
City	:	LAWRENCE
State	:	MA
Zip	:	01843-2340
Country	:	US
Telephone Number	:	978-975-5970
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2020
Last Update Date	:	05/11/2026

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Directions to “ MACKENZIE OSBORN ” Practice Location

Language	Start Address	Practice Location

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