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General NPI Number Information
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NPI Number | 1114394954
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Entity Type | Individual
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Provider Name | JULIE ANN O'DONNELL LP
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Gender | Female
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Dates
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Enumeration Date | 08/27/2015
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Last Update Date | 10/16/2023
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Provider Practice Location Address
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Address Line | 811 S BUSINESS HIGHWAY 13
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City | LEXINGTON
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State | MO
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Zip | 64067-1515
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Country | US
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Telephone | 660-251-6440
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Fax | 660-251-6441
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Provider Business Mailing Address
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Address Line | 811 S BUSINESS HIGHWAY 13
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City | LEXINGTON
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State | MO
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Zip | 64067-1515
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Country | US
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Telephone | 660-251-6440
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Fax | 660-251-6441
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2018012574
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 2575
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License Number State | KS
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