| NPI | 1326515040 |
|---|---|
| Other Name | MICHAEL LAMONT OSBORNE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA 1394) |
| Enumeration Date | 2018-10-31 |
| Last Update Date | 2021-06-01 |