Provider Demographics
NPI:1255484317
Name:OSBORNE, KENT ROBERT (LMFT)
Entity Type:Individual
Prefix:
First Name:KENT
Middle Name:ROBERT
Last Name:OSBORNE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6798 CROSSWINDS DR N
Mailing Address - Street 2:SUITE B-102
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-8603
Mailing Address - Country:US
Mailing Address - Phone:727-381-9400
Mailing Address - Fax:727-381-9181
Practice Address - Street 1:6798 CROSSWINDS DR N
Practice Address - Street 2:SUITE B-102
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-8603
Practice Address - Country:US
Practice Address - Phone:727-381-9400
Practice Address - Fax:727-381-9181
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT1045106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist