Individual
SHELLY MARIE OSBORNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
112 SHOSHONE ST E STE 2, TWIN FALLS, ID 83301-6185
(208) 860-8203
Mailing address
647 POLE LINE RD, TWIN FALLS, ID 83301-4083
(208) 860-8203
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC-5757
ID
Other
Enumeration date
05/07/2019
Last updated
05/07/2019
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