Provider Demographics
NPI:1750571931
Name:OSBORN, ROBIN DENISE (CSAC II)
Entity type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:DENISE
Last Name:OSBORN
Suffix:
Gender:F
Credentials:CSAC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 S PRAIRIE STREET
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63825
Mailing Address - Country:US
Mailing Address - Phone:573-568-2116
Mailing Address - Fax:573-568-2997
Practice Address - Street 1:206 S PRAIRIE STREET
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:MO
Practice Address - Zip Code:63825
Practice Address - Country:US
Practice Address - Phone:573-568-2116
Practice Address - Fax:573-568-2997
Is Sole Proprietor?:No
Enumeration Date:2007-07-25
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2808101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)