Provider Demographics
NPI:1568842474
Name:O'CONNOR, BRENDA (MA)
Entity type:Individual
Prefix:MS
First Name:BRENDA
Middle Name:
Last Name:O'CONNOR
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 1:53 STAFFORD RD
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01521-2804
Mailing Address - Country:US
Mailing Address - Phone:508-344-8480
Mailing Address - Fax:
Practice Address - Street 1:53 STAFFORD RD
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MA
Practice Address - Zip Code:01521-2804
Practice Address - Country:US
Practice Address - Phone:508-344-8480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-05
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health