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General NPI Number Information
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NPI Number | 1184663767
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Entity Type | Individual
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Provider Name | CAROL CAMPBELL O'DONOGHUE CNM
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Gender | Female
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 01/26/2026
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Provider Practice Location Address
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Address Line | 600 HAVERFORD RD STE G104
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City | HAVERFORD
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State | PA
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Zip | 19041-1139
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Country | US
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Telephone | 610-649-6344
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Fax | 610-649-6930
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Provider Business Mailing Address
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Address Line | 607 W UPSAL ST
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City | PHILADELPHIA
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State | PA
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Zip | 19119-3627
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Country | US
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Telephone | 610-649-6344
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Fax | 610-649-6930
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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 | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | MW010091
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | AMF000116
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License Number State | PA
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