Provider Demographics
NPI:1427467760
Name:O'HARA, MICHAEL LOUIS JR (PSYD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LOUIS
Last Name:O'HARA
Suffix:JR
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 S US HIGHWAY 1
Mailing Address - Street 2:SUITE 360A
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33477-5976
Mailing Address - Country:US
Mailing Address - Phone:561-748-4050
Mailing Address - Fax:561-427-1705
Practice Address - Street 1:825 S US HIGHWAY 1
Practice Address - Street 2:SUITE 360A
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477-5976
Practice Address - Country:US
Practice Address - Phone:561-748-4050
Practice Address - Fax:561-427-1705
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6571103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist