Healthcare Provider Details
I. General information
NPI: 1831608744
Provider Name (Legal Business Name): THOMAS JOHN O'HARA II MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 09/22/2017
Last Update Date: 08/03/2025
Certification Date: 08/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
630 CHURCHMANS RD STE 100A
NEWARK DE
19702-1943
US
IV. Provider business mailing address
630 CHURCHMANS RD STE 100A
NEWARK DE
19702-1943
US
V. Phone/Fax
- Phone: 302-544-5055
- Fax:
- Phone: 302-544-5055
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 235Z00000X |
| Taxonomy | Speech-Language Pathologist |
| License Number | O1-0012255 |
| License Number State | DE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: