Organization
NEIL F. O'DONNELL, PHD, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANN CLARE O'DONNELL PSYD (PARTNER)
(231) 929-9511
Entity
Organization
Contact information
Practice address
2150 S AIRPORT RD W, SUITEA, TRAVERSE CITY, MI 49684-4705
(231) 929-9511
(231) 929-4790
Mailing address
2150 S AIRPORT RD W, SUITEA, TRAVERSE CITY, MI 49684-4705
(231) 929-9511
(231) 929-4790
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301011534
MI
103TC0700X
Clinical Psychologist
6301011799
MI
103TC2200X
Clinical Child & Adolescent Psychologist
6301011799
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
68-0-B8-1130-0
BLUE CROSS BLUE SHEILD MICHIGAN
MI
01
—
68-0-B8-4532-0
BLUE CROSS BLUE SHEILD MICHIGAN
MI
Enumeration date
01/28/2011
Last updated
01/28/2011
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