Provider Demographics
NPI:1982424321
Name:OSBOURN, ALEXANDRIA PAIGE
Entity type:Individual
Prefix:MISS
First Name:ALEXANDRIA
Middle Name:PAIGE
Last Name:OSBOURN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9930 BOSTON HARBOR DR
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:76227-8521
Mailing Address - Country:US
Mailing Address - Phone:972-217-2064
Mailing Address - Fax:
Practice Address - Street 1:9300 JOHN HICKMAN PKWY STE 1104
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-5948
Practice Address - Country:US
Practice Address - Phone:469-750-5874
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7578103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty