Provider Demographics
NPI:1225350598
Name:OSBORNE-OLIVER, KRISTINA M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KRISTINA
Middle Name:M
Last Name:OSBORNE-OLIVER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3761 CARMAN RD
Mailing Address - Street 2:C/O CAPITAL PSYCHOLOGY
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12303-5418
Mailing Address - Country:US
Mailing Address - Phone:518-355-5800
Mailing Address - Fax:518-355-5801
Practice Address - Street 1:3761 CARMAN RD
Practice Address - Street 2:C/O CAPITAL PSYCHOLOGY
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303-5418
Practice Address - Country:US
Practice Address - Phone:518-355-5800
Practice Address - Fax:518-355-5801
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018348-1103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool