MEDICARE: REBECCA OSBON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	3483	LA

General Provider Information

NPI Number	:	1134599467
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA OSBON

Provider Business Mailing Address
First Line	:	46524 PINE HILL CT
Second Line	:
City	:	HAMMOND
State	:	LA
Zip	:	70401-8220
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1417 W MORRIS AVE
Second Line	:	SUITE E
City	:	HAMMOND
State	:	LA
Zip	:	70403-3854
Country	:	US
Telephone Number	:	985-542-9949
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2015
Last Update Date	:	09/29/2015

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Directions to “ REBECCA OSBON ” Practice Location

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