Provider Demographics
NPI:1922437656
Name:OSBORNE, RICHARD JR (MS, OTR/L)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:OSBORNE
Suffix:JR
Gender:M
Credentials:MS, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9714 SPINNAKER ST
Mailing Address - Street 2:
Mailing Address - City:CHELTENHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20623-1354
Mailing Address - Country:US
Mailing Address - Phone:646-623-6581
Mailing Address - Fax:301-782-3340
Practice Address - Street 1:2616 ROSE MOUNT LN
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-1878
Practice Address - Country:US
Practice Address - Phone:646-623-6581
Practice Address - Fax:301-782-3340
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05040225X00000X
DCOT010000831225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist