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General NPI Number Information
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NPI Number | 1780118547
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Entity Type | Organization
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Legal Business Name | OSBORNE LLC
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Dates
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Enumeration Date | 04/18/2017
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Last Update Date | 04/18/2017
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Provider Practice Location Address
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Address Line | 1018 THOMASVILLE ROAD
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City | TALLAHASSEE
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State | FL
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Zip | 32303
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Country | US
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Telephone | 850-251-8500
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Fax | 850-344-9092
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Provider Business Mailing Address
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Address Line | 2408 IONIC COURT
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City | TALLAHASSEE
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State | FL
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Zip | 32303
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Country | US
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Telephone | 850-322-7858
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Fax | 850-344-9092
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. MENETTA OSBORNE
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Credential |
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Telephone | 850-322-7858
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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 | SW13824
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License Number State | FL
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