Provider Demographics
NPI:1528341310
Name:O'DONNELL, HEATHER P (MA)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:P
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 1:1134 DRIVER PL
Mailing Address - Street 2:
Mailing Address - City:WESCOSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18106-9653
Mailing Address - Country:US
Mailing Address - Phone:610-295-2754
Mailing Address - Fax:
Practice Address - Street 1:1134 DRIVER PL
Practice Address - Street 2:
Practice Address - City:WESCOSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18106-9653
Practice Address - Country:US
Practice Address - Phone:610-295-2754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-28
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health