| Doctor Name: | KATHRYN C. STACKPOLE OSBORNE |
| NPI Number: | 1265551147 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 089000725 |
| Business Practice Address: | 111 Main St Hyde Park, VT - 05655 |
| Business Phone Number: | 8028886215 |
| Business Fax Number: | 8028889474 |
| Mailing Address: | Po Box 24, LAKE ELMORE |
| State: | VT |
| Postal Code: | 056570024 |
| Phone Number: | 8028886215 |
| Fax Number: | 8028889474 |
| NPI Enumeration Date: | 03/29/2007 |
| NPI Last Update Date: | 10/01/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 089000725 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |