| NPI | 1922716315 |
|---|---|
| Former Name | MYCHALEA ROSE OSBORN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR 1039713) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2022-11-14 |
| Last Update Date | 2024-08-08 |