MEDICARE: RAYNE OSBORN

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1861892473
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAYNE OSBORN

Provider Business Mailing Address
First Line	:	4525 N SOONER RD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73141-9530
Country	:	US
Telephone Number	:	405-301-3482
Fax Number	:

Provider Business Practice Location Address
First Line	:	4525 N SOONER RD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73141-9530
Country	:	US
Telephone Number	:	405-301-3482
Fax Number	:

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

Provider Enumeration Date	:	09/02/2014
Last Update Date	:	09/02/2014

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Directions to “ RAYNE OSBORN ” Practice Location

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