Provider Demographics
NPI:1689295826
Name:OSBORN WELLNESS AND COUNSELING
Entity Type:Organization
Organization Name:OSBORN WELLNESS AND COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:OSBORN
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:407-607-4901
Mailing Address - Street 1:20 W LUCERNE CIR APT 111
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-3703
Mailing Address - Country:US
Mailing Address - Phone:407-607-4901
Mailing Address - Fax:
Practice Address - Street 1:90 FOX RIDGE CT # B
Practice Address - Street 2:
Practice Address - City:DEBARY
Practice Address - State:FL
Practice Address - Zip Code:32713-2719
Practice Address - Country:US
Practice Address - Phone:407-607-4901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-28
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)