Provider Demographics
NPI:1831930098
Name:OSBORNE, MARIAH LYNNE
Entity type:Individual
Prefix:
First Name:MARIAH
Middle Name:LYNNE
Last Name:OSBORNE
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 1:181 ZEIGENBEIN RD
Mailing Address - Street 2:
Mailing Address - City:SAINT ROBERT
Mailing Address - State:MO
Mailing Address - Zip Code:65584-4670
Mailing Address - Country:US
Mailing Address - Phone:573-842-0001
Mailing Address - Fax:
Practice Address - Street 1:12225 PULASKI AVE
Practice Address - Street 2:
Practice Address - City:FORT LEONARD WOOD
Practice Address - State:MO
Practice Address - Zip Code:65473-1972
Practice Address - Country:US
Practice Address - Phone:573-842-2650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant