Individual
DR. ANN CLARE O'DONNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
2150 S AIRPORT RD W, SUITE A, TRAVERSE CITY, MI 49684-4705
(231) 929-9511
(231) 929-4790
Mailing address
2150 S AIRPORT RD W, SUITE A, TRAVERSE CITY, MI 49684-4705
(231) 929-9511
(231) 929-4790
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301011799
MI
103TC2200X
Clinical Child & Adolescent Psychologist
6301011799
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11413109
CAQH
MI
01
—
467872
VALUE OPTIONS
MI
01
—
68-0-B8-1130-0
BLUE CROSS
MI
Enumeration date
02/06/2007
Last updated
01/28/2011
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