Healthcare Provider Details

I. General information

NPI: 1245404284
Provider Name (Legal Business Name): BONNIE HUGHES OSGOOD MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2008
Last Update Date: 04/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

416A N FERNCREEK AVE
ORLANDO FL
32803-5432
US

IV. Provider business mailing address

1560 GLENCOE RD
WINTER PARK FL
32789-5736
US

V. Phone/Fax

Practice location:
  • Phone: 407-898-7798
  • Fax: 407-894-6010
Mailing address:
  • Phone: 407-629-6949
  • Fax: 407-894-6010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: