Kysa C Radley Osborne, LCSW
Social Worker, Clinical in South Salt Lake, UT. Individual provider (NPI-1).
NPI number1649909482
StatusActive
Last updated in NPPESJun 7, 2022
Details
- NPI
- 1649909482
- Entity type
- Individual (NPI-1)
- Name
- Ms. Kysa C Radley Osborne
- Credential
- LCSW
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 7, 2022
- Certification date
- Jun 7, 2022
- Last updated
- Jun 7, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 6124439-3501 | UT | Yes |
Practice location
2500 S State StSouth Salt Lake, UT 84115-3164
Phone 385-646-5000
Mailing address
13737 S Annie Lace CirDraper, UT 84020-7500
Phone 801-541-5943 · Fax 385-646-4919
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