Doctor Name: | NICHOLE HARMONY O'CONNOR |
NPI Number: | 1558706275 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | CO60340882 |
Business Practice Address: | 520 Spring St Friday Harbor, WA - 982508057 |
Business Phone Number: | 3603787524 |
Business Fax Number: | |
Mailing Address: | 1901 E Viewmont Dr, MOUNT VERNON |
State: | WA |
Postal Code: | 982732606 |
Phone Number: | 2522595782 |
Fax Number: | |
NPI Enumeration Date: | 05/08/2013 |
NPI Last Update Date: | 05/08/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | CO60340882 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |