Provider Demographics
NPI:1528471893
Name:ANNMARIE O'DANIEL
Entity type:Organization
Organization Name:ANNMARIE O'DANIEL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRIVATE PRACTICE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ANNMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:O'DANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:541-829-2580
Mailing Address - Street 1:260 SW MADISON AVE
Mailing Address - Street 2:SUITE 114
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-4798
Mailing Address - Country:US
Mailing Address - Phone:541-829-2580
Mailing Address - Fax:541-753-0184
Practice Address - Street 1:260 SW MADISON AVE
Practice Address - Street 2:SUITE 114
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97333-4798
Practice Address - Country:US
Practice Address - Phone:541-829-2580
Practice Address - Fax:541-753-0184
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-04
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC2654101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty