Provider Demographics
NPI:1215050539
Name:O'CONNER, DENISE LYNN (CRC)
Entity type:Individual
Prefix:MS
First Name:DENISE
Middle Name:LYNN
Last Name:O'CONNER
Suffix:
Gender:F
Credentials:CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10046 KETCH RD
Mailing Address - Street 2:
Mailing Address - City:PLAIN CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43064-9706
Mailing Address - Country:US
Mailing Address - Phone:614-306-6211
Mailing Address - Fax:614-733-0610
Practice Address - Street 1:10046 KETCH RD
Practice Address - Street 2:
Practice Address - City:PLAIN CITY
Practice Address - State:OH
Practice Address - Zip Code:43064-9706
Practice Address - Country:US
Practice Address - Phone:614-306-6211
Practice Address - Fax:614-733-0610
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34489225C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor