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Individual

KALYSSA RAINE OSGOOD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
779 EAST AVE APT 12, ROCHESTER, NY 14607-2176
(607) 331-6021
Mailing address
779 EAST AVE APT 12, ROCHESTER, NY 14607-2176
(607) 331-6021

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
2761916
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
74275292200
FIDELIS
NY
Enumeration date
05/10/2022
Last updated
05/10/2022
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