Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor |
NPI | 1306327911 |
---|---|
Provider Name | Patricia Ann Osborne |
First Address | Lafayette, LA 70508-7449 |
Second Address | Lafayette, LA 70508-7449 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2018 |
Last Update Date | 22/08/2018 |