Provider Demographics
NPI:1548455272
Name:O'GARA, FLORENCE K (LMSW, RN)
Entity type:Individual
Prefix:MS
First Name:FLORENCE
Middle Name:K
Last Name:O'GARA
Suffix:
Gender:F
Credentials:LMSW, RN
Other - Prefix:MS
Other - First Name:CASEY
Other - Middle Name:
Other - Last Name:O'GARA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW, RN
Mailing Address - Street 1:3621 S STATE ST
Mailing Address - Street 2:700 KMS PLACE
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108
Mailing Address - Country:US
Mailing Address - Phone:734-936-2047
Mailing Address - Fax:
Practice Address - Street 1:4260 PLYMOUTH RD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109
Practice Address - Country:US
Practice Address - Phone:734-936-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-06
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801072434104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker