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Individual
MARY LARISA O'HANNON
Active
Individual
MARY LARISA O'HANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-A
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
P007725
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
P007725
—
NC
Enumeration date
06/13/2014
Last updated
12/10/2015
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