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NPI Code Detail

MEDICARE: LORI OSACHY M.S.S., L.C.S.W.

MEDICARE:   LORI  OSACHY  M.S.S., L.C.S.W.
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
11041C0700XClinical Social WorkerSW5916FL

General Provider Information

NPI Number : 1306907647
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORI OSACHY M.S.S., L.C.S.W.
Provider Business Mailing Address
First Line : 1545 LANDON AVE
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207-8671
Country : US
Telephone Number : 904-737-3232
Fax Number : 866-631-9482
Provider Business Practice Location Address
First Line : 1545 LANDON AVE
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32207-8671
Country : US
Telephone Number : 904-737-3232
Fax Number : 904-396-4505
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2006
Last Update Date : 10/01/2015

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