Provider Information for 1043637721
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RICHARD NATHANIEL OSBORN MS, NCC, LPC
Sex: Male
NPI: 1043637721
Last Updated: 2020-04-02
Certification Date: 2020-04-02
Certification Date: 2020-04-02
Details
| Name | Value | ||||||||
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| NPI | 1043637721 | ||||||||
| Enumeration Date | 2014-03-19 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2623 E 2ND ST TULSA, OK 74104-1905 United States Phone: 918-637-0799 | Fax: | ||||||||
| Primary Practice Address | 6216 S LEWIS AVE STE 140 TULSA, OK 74136-1051 United States Phone: 918-552-0657 | Fax: | ||||||||
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