Basic Information
| Provider Information | |||||||||
| NPI: | 1790811743 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | OSBAHR | ||||||||
| FirstName: | KENDAL | ||||||||
| MiddleName: | MARI | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LMHP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3874 ARBOR ST | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 681053470 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4025518379 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5115 F ST | ||||||||
| Address2: | |||||||||
| City: | OMAHA | ||||||||
| State: | NE | ||||||||
| PostalCode: | 68117 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4023979866 | ||||||||
| FaxNumber: | 4023971404 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/26/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 2547 | NE | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.