Doctor Name: | LYNN MARIE O'DELL |
NPI Number: | 1750530135 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCPC |
License Number: | 513 |
Business Practice Address: | 1510 W Ottawa Rd Paxton, IL - 609574090 |
Business Phone Number: | 2173794302 |
Business Fax Number: | 2173794306 |
Mailing Address: | 1510 W Ottawa Rd, P.o Box 162 PAXTON |
State: | IL |
Postal Code: | 609574090 |
Phone Number: | 2173794302 |
Fax Number: | 2173794306 |
NPI Enumeration Date: | 09/10/2008 |
NPI Last Update Date: | 07/22/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 513 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |