Provider Demographics
NPI:1336325950
Name:OSBORNE, YVONNE HARDAWAY (PHD)
Entity Type:Individual
Prefix:DR
First Name:YVONNE
Middle Name:HARDAWAY
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 NORTH MAIN STREET
Mailing Address - Street 2:SUITE 2315
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38103
Mailing Address - Country:US
Mailing Address - Phone:901-527-2248
Mailing Address - Fax:901-523-2029
Practice Address - Street 1:670 COLONIAL RD
Practice Address - Street 2:SUITE 5
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38117-5160
Practice Address - Country:US
Practice Address - Phone:901-681-0851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-14
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0000002702103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical