Provider Demographics
NPI:1437474350
Name:OSOM, UDUAK (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:UDUAK
Middle Name:
Last Name:OSOM
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1090 HOMESTEAD RD
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-5402
Mailing Address - Country:US
Mailing Address - Phone:408-241-2229
Mailing Address - Fax:408-241-3156
Practice Address - Street 1:1090 HOMESTEAD RD
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-5402
Practice Address - Country:US
Practice Address - Phone:408-241-2229
Practice Address - Fax:408-241-3156
Is Sole Proprietor?:No
Enumeration Date:2010-04-03
Last Update Date:2010-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP10585235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist