Individual
NEALA ANN O'HARA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
TLLP
Contact information
Practice address
1777 AXTELL DR STE 100, TROY, MI 48084-4400
(248) 613-5377
Mailing address
1777 AXTELL DR STE 100, TROY, MI 48084-4400
(248) 613-5377
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
6301017428
MI
103TC1900X
Counseling Psychologist
—
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/11/2017
Last updated
05/08/2018
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