Provider Demographics
NPI:1275814782
Name:OSMAN, SHAWNA L
Entity Type:Individual
Prefix:
First Name:SHAWNA
Middle Name:L
Last Name:OSMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 BURRINGTON RD
Mailing Address - Street 2:
Mailing Address - City:HEATH
Mailing Address - State:MA
Mailing Address - Zip Code:01346-9721
Mailing Address - Country:US
Mailing Address - Phone:413-774-1000
Mailing Address - Fax:
Practice Address - Street 1:1 ARCH PL
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-2457
Practice Address - Country:US
Practice Address - Phone:413-774-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-30
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health