Individual
COLLEEN M O'DONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAT
Contact information
Practice address
211 BROADWAY, SUITE 207, LYNBROOK, NY 11563-3290
(516) 458-5664
Mailing address
211 BROADWAY, SUITE 207, LYNBROOK, NY 11563-3290
(516) 458-5664
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
05 000491
NY
Other
Enumeration date
12/06/2012
Last updated
12/06/2012
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