Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | NA |
NPI | 1154649986 |
---|---|
Provider Name | Ms. Carol Jane Osment |
First Address | Loris, SC 29569-3122 |
Second Address | Myrtle Beach, SC 29577-3722 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2010 |
Last Update Date | 04/05/2010 |