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Individual

KENNETH OSBORNE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CASAC

Contact information

Practice address
1037 MAIN ST, HUDSON RIVER HEALTHCARE, INC., PEEKSKILL, NY 10566-2913
(914) 734-8800
(914) 734-8745
Mailing address
1200 BROWN ST, 4TH FLOOR - CREDENTIALING, PEEKSKILL, NY 10566-3617
(914) 734-8858
(914) 734-8745

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
12988
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00473038
NY
Enumeration date
12/27/2006
Last updated
07/09/2007
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