Provider Demographics
NPI:1689499741
Name:OSBERG, GRACE (M ED)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:OSBERG
Suffix:
Gender:F
Credentials:M ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:373 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PLYMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:02367-1512
Mailing Address - Country:US
Mailing Address - Phone:339-244-1455
Mailing Address - Fax:
Practice Address - Street 1:373 MAIN ST
Practice Address - Street 2:
Practice Address - City:PLYMPTON
Practice Address - State:MA
Practice Address - Zip Code:02367-1512
Practice Address - Country:US
Practice Address - Phone:339-244-1455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-22
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health