Provider Demographics
NPI:1023067956
Name:OSBORNE, LISA KEY (MS, CCC-A)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:KEY
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:ELIZABETH
Other - Last Name:KEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1000 JOHNSON FERRY RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1606
Mailing Address - Country:US
Mailing Address - Phone:404-851-6117
Mailing Address - Fax:404-256-1152
Practice Address - Street 1:3400 OLD MILTON PKWY # C
Practice Address - Street 2:STE. 365
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-3707
Practice Address - Country:US
Practice Address - Phone:404-446-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT005986231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist