| Doctor Name: | DR. KIM MARIE O'DONNELL |
| NPI Number: | 1043547763 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | 002084 |
| Business Practice Address: | 142 Elm St Cheshire, CT - 064102808 |
| Business Phone Number: | 2036682223 |
| Business Fax Number: | |
| Mailing Address: | 142 Elm St, CHESHIRE |
| State: | CT |
| Postal Code: | 064102808 |
| Phone Number: | 2036682223 |
| Fax Number: | |
| NPI Enumeration Date: | 11/17/2009 |
| NPI Last Update Date: | 11/17/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TB0200X |
| License Number: | 002084 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Cognitive & Behavioral |
| Taxonomy Definition: | |