Provider Demographics
NPI:1891009379
Name:O'HARE, DEANNA LENORE
Entity type:Individual
Prefix:MS
First Name:DEANNA
Middle Name:LENORE
Last Name:O'HARE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2270 ASHLEY CROSSING DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-5732
Mailing Address - Country:US
Mailing Address - Phone:843-571-3967
Mailing Address - Fax:843-556-0350
Practice Address - Street 1:2270 ASHLEY CROSSING DR
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5732
Practice Address - Country:US
Practice Address - Phone:843-571-3967
Practice Address - Fax:843-556-0350
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC990156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician