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General NPI Number Information
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NPI Number | 1326072372
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Entity Type | Individual
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Provider Name | REUBEN E OSOLLO LCSW
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Gender | Male
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Dates
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Enumeration Date | 07/10/2006
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Last Update Date | 11/14/2015
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Provider Practice Location Address
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Address Line | 10613 N HAYDEN RD STE J-100
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-5683
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Country | US
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Telephone | 480-206-8295
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Fax | 480-951-4307
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Provider Business Mailing Address
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Address Line | 10613 N HAYDEN RD STE J-100
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-5683
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Country | US
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Telephone | 480-206-8295
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Fax | 480-951-4307
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW-2890
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License Number State | AZ
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