Healthcare Provider Details

I. General information

NPI: 1174645949
Provider Name (Legal Business Name): JOSEPH PAUL OSOSKIE LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26650 EUREKA RD SUITE A
TAYLOR MI
48180-4835
US

IV. Provider business mailing address

26650 EUREKA RD SUITE A
TAYLOR MI
48180-4835
US

V. Phone/Fax

Practice location:
  • Phone: 734-955-3550
  • Fax: 734-955-3562
Mailing address:
  • Phone: 734-955-3550
  • Fax: 734-955-3562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6801015943
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: