| Doctor Name: | ROBERT A MCDONNELL |
| NPI Number: | 1235468182 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LADC |
| License Number: | LC4844 |
| Business Practice Address: | 19 River Rd Hiram, ME - 040413516 |
| Business Phone Number: | 2079351078 |
| Business Fax Number: | |
| Mailing Address: | 142 Main St, BROWNFIELD |
| State: | ME |
| Postal Code: | 040104707 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 12/23/2009 |
| NPI Last Update Date: | 06/13/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | LC4844 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |