Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | C0500221 | OH |
NPI | 1003056730 |
---|---|
Provider Name | Mr. Thomas William O'donnell |
First Address | Niles, OH 44446-2352 |
Second Address | Niles, OH 44446-2352 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2009 |
Last Update Date | 20/02/2009 |