Individual
CONNIE MAE OSBORNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MED.
Contact information
Practice address
921 14TH AVE, LONGVIEW, WA 98632-2316
(360) 423-0203
(360) 423-2311
Mailing address
560 20TH AVE, LONGVIEW, WA 98632-1518
(136) 042-5669
(136) 042-3231
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
RC00055832
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RC00055832
REGISTERED COUNSELOR
WA
Enumeration date
04/12/2007
Last updated
07/08/2007
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