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General NPI Number Information
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NPI Number | 1093045320
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Entity Type | Individual
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Provider Name | TOBY W OSBURN L.P.C.
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Gender | Male
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Dates
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Enumeration Date | 01/08/2010
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Last Update Date | 01/08/2010
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Provider Practice Location Address
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Address Line | 194 WILLIAMSBURG ST HERITAGE SQUARE OFFICE PARK, BLDG. B
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City | LAKE CHARLES
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State | LA
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Zip | 70605-5720
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Country | US
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Telephone | 337-912-9026
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4755
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City | LAKE CHARLES
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State | LA
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Zip | 70606-4755
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Country | US
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Telephone | 337-912-9026
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 4518
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 19228
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License Number State | TX
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