Provider Demographics
NPI:1386756682
Name:OSENI, RENEA JOHNSON (PHD)
Entity type:Individual
Prefix:DR
First Name:RENEA
Middle Name:JOHNSON
Last Name:OSENI
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4343 SHALLOWFORD RD
Mailing Address - Street 2:SUITE G-2
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-5057
Mailing Address - Country:US
Mailing Address - Phone:678-585-9260
Mailing Address - Fax:678-585-9261
Practice Address - Street 1:4343 SHALLOWFORD RD
Practice Address - Street 2:SUITE G-2
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-5057
Practice Address - Country:US
Practice Address - Phone:678-585-9260
Practice Address - Fax:678-585-9261
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004195101YP2500X
LAMFT637106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist