MEDICARE: MRS. NORA E O'HARA LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	925-124	WI

General Provider Information

NPI Number	:	1376882662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NORA E O'HARA LMFT

Provider Business Mailing Address
First Line	:	W8650 690TH AVE
Second Line	:
City	:	RIVER FALLS
State	:	WI
Zip	:	54022-4115
Country	:	US
Telephone Number	:	715-425-2897
Fax Number	:

Provider Business Practice Location Address
First Line	:	1477 S KNOWLES AVE STE 130
Second Line	:
City	:	NEW RICHMOND
State	:	WI
Zip	:	54017-2568
Country	:	US
Telephone Number	:	715-246-4840
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2013
Last Update Date	:	02/06/2013

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