Provider Demographics
NPI:1437179025
Name:OSBORNE, ROBIN BENNETT (PHD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:BENNETT
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:PO BOX 187
Mailing Address - Street 2:THE LIVERY HOUSE
Mailing Address - City:EAST THETFORD
Mailing Address - State:VT
Mailing Address - Zip Code:05043-0187
Mailing Address - Country:US
Mailing Address - Phone:802-785-4262
Mailing Address - Fax:
Practice Address - Street 1:321 RT 113
Practice Address - Street 2:THE LIVERY HOUSE
Practice Address - City:EAST THETFORD
Practice Address - State:VT
Practice Address - Zip Code:05043-9510
Practice Address - Country:US
Practice Address - Phone:802-785-4262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT402103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical