Provider Demographics
NPI:1689174716
Name:OSSA, CARRIE M
Entity Type:Individual
Prefix:MRS
First Name:CARRIE
Middle Name:M
Last Name:OSSA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2771 MARIAH DR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-7162
Mailing Address - Country:US
Mailing Address - Phone:305-989-9359
Mailing Address - Fax:
Practice Address - Street 1:2771 MARIAH DR
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-7162
Practice Address - Country:US
Practice Address - Phone:305-989-9359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-15
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker