Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TC1900X | Counseling Psychologist | MI | |
Y | 103TC1900X | Counseling Psychologist | 6301017428 | MI |
NPI | 1033631122 |
---|---|
Provider Name | Neala Ann O'hara |
First Address | Troy, MI 48084-4400 |
Second Address | Troy, MI 48084-4400 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2017 |
Last Update Date | 08/05/2018 |