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General NPI Number Information
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NPI Number | 1699982090
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Entity Type | Individual
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Provider Name | MARY LYNN OSSOWSKI LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1201 S VETERANS PKWY SUITE B
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City | SPRINGFIELD
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State | IL
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Zip | 62704-6321
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Country | US
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Telephone | 217-793-2770
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Fax | 217-793-2887
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Provider Business Mailing Address
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Address Line | 4018 MILL STONE DR
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City | SPRINGFIELD
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State | IL
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Zip | 62711-8045
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Country | US
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Telephone | 217-787-9832
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State | IL
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