Provider Demographics
NPI:1821300575
Name:OSMOND, AMY LOUCINDA (BSW)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:LOUCINDA
Last Name:OSMOND
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 255
Mailing Address - Street 2:
Mailing Address - City:GOTEBO
Mailing Address - State:OK
Mailing Address - Zip Code:73041-0255
Mailing Address - Country:US
Mailing Address - Phone:580-318-3938
Mailing Address - Fax:
Practice Address - Street 1:70-100 NORTH 31ST STREET
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:OK
Practice Address - Zip Code:73601
Practice Address - Country:US
Practice Address - Phone:580-323-6021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-10
Last Update Date:2010-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health