MEDICARE: MS. JOANNA LEIGH OSMOND LCSW

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	1041C0700X	Clinical Social Worker	C003797	NC

General Provider Information

NPI Number	:	1265937908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOANNA LEIGH OSMOND LCSW

Provider Business Mailing Address
First Line	:	308 VALLE MEADOWS TRL
Second Line	:
City	:	SUGAR GROVE
State	:	NC
Zip	:	28679-9762
Country	:	US
Telephone Number	:	828-963-0325
Fax Number	:

Provider Business Practice Location Address
First Line	:	308 VALLE MEADOWS TRL
Second Line	:
City	:	SUGAR GROVE
State	:	NC
Zip	:	28679-9762
Country	:	US
Telephone Number	:	828-963-0325
Fax Number	:

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

Provider Enumeration Date	:	03/26/2018
Last Update Date	:	03/26/2018

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