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Individual

DR. GARY WAYNE OSBORNE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC, MHSP

Contact information

Practice address
1629 E MAIN ST, HUMBOLDT, TN 38343
(731) 618-0266
(731) 824-5398
Mailing address
113 ROLLING OAKS DR, HUMBOLDT, TN 38343-8586
(731) 618-0055
(731) 824-5398

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC583
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
229202000
MAGELLAN HEALTH SERVICES
01
3102484
BCBS
TN
01
7017081
AETNA
Enumeration date
10/03/2006
Last updated
11/20/2024
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