Healthcare Provider Details

I. General information

NPI: 1659920379
Provider Name (Legal Business Name): KATIE E OSBORN PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATIE E OSBORN SPIRKO PSYD

II. Dates (important events)

Enumeration Date: 09/05/2019
Last Update Date: 11/27/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 DIVISION ST STE 405
NASHVILLE TN
37203-4495
US

IV. Provider business mailing address

551 BONERWOOD DR
NASHVILLE TN
37211-5213
US

V. Phone/Fax

Practice location:
  • Phone: 615-274-8400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3631
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: