Provider Demographics
NPI:1558756346
Name:OSBORNE, FIONA FAITH (PHD)
Entity Type:Individual
Prefix:DR
First Name:FIONA
Middle Name:FAITH
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 1:3841 ENVIRON BLVD
Mailing Address - Street 2:APT 231
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33319-4293
Mailing Address - Country:US
Mailing Address - Phone:954-309-7128
Mailing Address - Fax:
Practice Address - Street 1:3841 ENVIRON BLVD
Practice Address - Street 2:APT 231
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33319-4293
Practice Address - Country:US
Practice Address - Phone:954-309-7128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10112101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health