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Individual

MRS. KIMBERLY JILL OSBORNE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
EDS, LPC

Contact information

Practice address
1269 PARKER RD SE, CONYERS, GA 30094-5957
(404) 234-0546
(770) 761-9070
Mailing address
1269 PARKER RD SE, CONYERS, GA 30094-5957
(404) 234-0546
(770) 761-9070

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC006170
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003112500A
GA
05
003112503A
GA
05
003188998A
GA
Enumeration date
11/03/2010
Last updated
08/30/2021
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