Healthcare Provider Details

I. General information

NPI: 1275932360
Provider Name (Legal Business Name): LAYNEE MORGAN OSBORNE OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2014
Last Update Date: 08/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 KIMBERLY LN
WILLIAMSTOWN KY
41097-9458
US

IV. Provider business mailing address

104 SUMMERFIELD
DRY RIDGE KY
41035-7056
US

V. Phone/Fax

Practice location:
  • Phone: 859-824-7803
  • Fax:
Mailing address:
  • Phone: 859-588-4071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberR4534
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: