Provider Demographics
NPI:1164101499
Name:OSUNA SILES, JAVIER SR
Entity Type:Individual
Prefix:MR
First Name:JAVIER
Middle Name:
Last Name:OSUNA SILES
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 3RD ST N APT 623
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55401-2689
Mailing Address - Country:US
Mailing Address - Phone:763-477-8212
Mailing Address - Fax:
Practice Address - Street 1:370 SELBY AVE STE 215
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2855
Practice Address - Country:US
Practice Address - Phone:763-477-8212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-13
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling