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General NPI Number Information
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NPI Number | 1568165090
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Entity Type | Individual
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Provider Name | MR. JULIO D OSPINO
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Gender | Male
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Dates
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Enumeration Date | 03/23/2023
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 25028 104TH AVE SE
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City | KENT
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State | WA
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Zip | 98030-9310
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Country | US
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Telephone | 206-764-8019
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Fax |
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Provider Business Mailing Address
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Address Line | 103 DANBURY RD APT 6
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City | RIDGEFIELD
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State | CT
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Zip | 06877-4105
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Country | US
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Telephone | 203-815-4933
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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