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General NPI Number Information
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NPI Number | 1124141718
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Entity Type | Individual
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Provider Name | SANDRA SUE O'DONNELL LPC-MHSP
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Gender | Female
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Dates
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Enumeration Date | 04/09/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2021 RICHARD JONES RD SUITE 110
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City | NASHVILLE
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State | TN
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Zip | 37215-2860
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Country | US
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Telephone | 615-598-8315
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Fax |
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Provider Business Mailing Address
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Address Line | 1213 5TH AVE N
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City | NASHVILLE
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State | TN
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Zip | 37208-2723
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Country | US
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Telephone | 615-390-6439
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Fax |
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC1941
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License Number State | TN
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