Individual
MR. PATRICK JOSEPH OSMONSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LISAC, CCTP
Contact information
Practice address
3504 GLORIA AVE, BULLHEAD CITY, AZ 86442-8107
(928) 419-1627
Mailing address
3504 GLORIA AVE, BULLHEAD CITY, AZ 86442-8107
(928) 419-1627
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CADC00795-C
NV
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LISAC1619
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1437646429
NPI
—
Enumeration date
04/16/2018
Last updated
03/16/2021
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