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Individual

MR. JOHN W. O'DONOGHUE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMFT

Contact information

Practice address
3900 BARRETT DR, SUITE 301-B, RALEIGH, NC 27609-6641
(919) 341-2477
Mailing address
3900 BARRETT DR, SUITE 301-B, RALEIGH, NC 27609-6641
(919) 341-2477

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
1114
NC
106H00000X
Marriage & Family Therapist
MFC 40935
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6105123
NC
Enumeration date
07/21/2006
Last updated
07/09/2007
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