Provider Demographics
NPI:1023620184
Name:OSBORN, CHRISTINE ADAMS
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ADAMS
Last Name:OSBORN
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 1:32 DELAFIELD ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-6010
Mailing Address - Country:US
Mailing Address - Phone:203-914-9739
Mailing Address - Fax:
Practice Address - Street 1:32 DELAFIELD ISLAND RD
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-6010
Practice Address - Country:US
Practice Address - Phone:203-914-9739
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-20
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT46.004075-ASOC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health