| Doctor Name: | MRS. MARY ANNE O'CONNELL |
| NPI Number: | 1023334794 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMSW |
| License Number: | 6801085778 |
| Business Practice Address: | 2901 Easrt Grand River Ave C/o Pam Howell, MI - 48843 |
| Business Phone Number: | 5175481537 |
| Business Fax Number: | 5175489399 |
| Mailing Address: | 118 Fairview St, ANN ARBOR |
| State: | MI |
| Postal Code: | 481034024 |
| Phone Number: | 7346621959 |
| Fax Number: | 7346621959 |
| NPI Enumeration Date: | 04/20/2010 |
| NPI Last Update Date: | 04/20/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 6801085778 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |