Provider Demographics
NPI:1235446790
Name:OSGOOD, DOROTHY (PHD)
Entity Type:Individual
Prefix:DR
First Name:DOROTHY
Middle Name:
Last Name:OSGOOD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:DOROTHY
Other - Middle Name:
Other - Last Name:OSGOOD-SOJOURNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:108 SUMMERLAKE DR
Mailing Address - Street 2:
Mailing Address - City:NORTH AUGUSTA
Mailing Address - State:SC
Mailing Address - Zip Code:29860-8458
Mailing Address - Country:US
Mailing Address - Phone:803-279-6357
Mailing Address - Fax:803-705-7079
Practice Address - Street 1:108 SUMMERLAKE DR
Practice Address - Street 2:
Practice Address - City:NORTH AUGUSTA
Practice Address - State:SC
Practice Address - Zip Code:29860-8458
Practice Address - Country:US
Practice Address - Phone:803-279-6357
Practice Address - Fax:803-705-7079
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-04
Last Update Date:2010-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC91451041C0700X
GACSW0040971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical