Provider Demographics
NPI:1649483488
Name:OSBAHR, TRACY C (MA, CCC-S)
Entity type:Individual
Prefix:MS
First Name:TRACY
Middle Name:C
Last Name:OSBAHR
Suffix:
Gender:F
Credentials:MA, CCC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BRAY CT
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01002-9732
Mailing Address - Country:US
Mailing Address - Phone:413-253-3018
Mailing Address - Fax:
Practice Address - Street 1:23 SERVICE CENTER RD
Practice Address - Street 2:WESTERN REG HEALTH OFFICE
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3821
Practice Address - Country:US
Practice Address - Phone:413-586-7525
Practice Address - Fax:413-784-1037
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA865950235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist