O'Donnell, John M

O'Donnell, John M is an individual health care provider with primary practice located at 5225 N Ironwood Ln Suite # 212, Glendale WI 53217-4909. He recently has only one registered license in Behavioral Health & Social Service Providers / Cognitive & Behavioral, which is considered as his primary health care specialty. O'Donnell, John M can be contacted via phone (414) 962-1000.

Contact Information

Primary practice address
5225 N Ironwood Ln Suite # 212 Glendale WI 53217-4909
Phone: (414) 962-1000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Cognitive & Behavioral 103TB0200X 561-057 Wisconsin

Profile Details

NPI number 1962462093
LBN Legal business name O'Donnell, John M
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2006
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962462093 NPPES
Wisconsin MEDICAID 39055600

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