Provider Demographics
NPI:1508188350
Name:OSGOOD, YAMARI (OTR/L)
Entity Type:Individual
Prefix:MRS
First Name:YAMARI
Middle Name:
Last Name:OSGOOD
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 KINGS WAY ROAD
Mailing Address - Street 2:KINGS GRANT RETIREMENT COMMUNITY
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112
Mailing Address - Country:US
Mailing Address - Phone:276-634-1581
Mailing Address - Fax:
Practice Address - Street 1:350 KINGS WAY ROAD
Practice Address - Street 2:KINGS GRANT RETIREMENT COMMUNITY
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112
Practice Address - Country:US
Practice Address - Phone:276-634-1581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-22
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0119004630225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist