Individual
IDA M. O'DONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
813 BROADWAY, ART OF AWARENESS, INC., SOUTH PORTLAND, ME 04106-2708
(207) 799-1331
(207) 799-1350
Mailing address
813 BROADWAY, ART OF AWARENESS, INC., SOUTH PORTLAND, ME 04106-2708
(207) 799-1331
(207) 799-1350
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC4676
ME
Other
Enumeration date
07/28/2006
Last updated
05/16/2012
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