Provider Demographics
NPI:1316152762
Name:O'DONNELL, MARIE ANNE (MA)
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:ANNE
Last Name:O'DONNELL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 E BISHOP ST
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTE
Mailing Address - State:PA
Mailing Address - Zip Code:16823-1944
Mailing Address - Country:US
Mailing Address - Phone:814-355-8215
Mailing Address - Fax:
Practice Address - Street 1:316 E BISHOP ST
Practice Address - Street 2:
Practice Address - City:BELLEFONTE
Practice Address - State:PA
Practice Address - Zip Code:16823-1944
Practice Address - Country:US
Practice Address - Phone:814-355-8215
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC002782101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor