Individual
BEVERLY S. OSBORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW,ACSW
Contact information
Practice address
799 HOMBACH ST, SAINT IGNACE, MI 49781-1735
(906) 643-9150
Mailing address
799 HOMBACH ST, SAINT IGNACE, MI 49781-1735
(906) 643-9150
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801061211
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
216885
PPO
MI
Enumeration date
10/11/2019
Last updated
10/11/2019
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