Provider Demographics
NPI:1750634515
Name:OSMAN, KHANSA OSMAN (MS)
Entity Type:Individual
Prefix:MRS
First Name:KHANSA
Middle Name:OSMAN
Last Name:OSMAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1534B GREGG ST
Mailing Address - Street 2:
Mailing Address - City:PHILA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-4283
Mailing Address - Country:US
Mailing Address - Phone:693-602-4267
Mailing Address - Fax:
Practice Address - Street 1:2288 SECOND STREET PIKE STE 6
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-4108
Practice Address - Country:US
Practice Address - Phone:215-598-0223
Practice Address - Fax:215-598-9020
Is Sole Proprietor?:No
Enumeration Date:2012-10-18
Last Update Date:2012-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health