Provider Demographics
NPI:1689103517
Name:OSBORN, KABETH (MA CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:KABETH
Middle Name:
Last Name:OSBORN
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2828 NW 57TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112-7091
Mailing Address - Country:US
Mailing Address - Phone:405-286-3749
Mailing Address - Fax:866-435-3297
Practice Address - Street 1:2828 NW 57TH ST STE 100
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-7091
Practice Address - Country:US
Practice Address - Phone:405-286-3749
Practice Address - Fax:866-435-3297
Is Sole Proprietor?:No
Enumeration Date:2017-06-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4430235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist