MEDICARE: DR. ROBIN BENNETT OSBORNE PH.D.

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	103TC0700X	Clinical Psychologist	402	VT

General Provider Information

NPI Number	:	1437179025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBIN BENNETT OSBORNE PH.D.

Provider Business Mailing Address
First Line	:	PO BOX 187
Second Line	:	THE LIVERY HOUSE
City	:	EAST THETFORD
State	:	VT
Zip	:	05043-0187
Country	:	US
Telephone Number	:	802-785-4262
Fax Number	:

Provider Business Practice Location Address
First Line	:	321 RT 113
Second Line	:	THE LIVERY HOUSE
City	:	EAST THETFORD
State	:	VT
Zip	:	05043-9510
Country	:	US
Telephone Number	:	802-785-4262
Fax Number	:

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

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. ROBIN BENNETT OSBORNE PH.D.” Practice Location

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