Individual
MS. KYSA C RADLEY OSBORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2500 S STATE ST, SOUTH SALT LAKE, UT 84115-3164
(385) 646-5000
Mailing address
13737 S ANNIE LACE CIR, DRAPER, UT 84020-7500
(801) 541-5943
(385) 646-4919
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6124439-3501
UT
Other
Enumeration date
06/07/2022
Last updated
06/07/2022
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