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General NPI Number Information
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NPI Number | 1245470970
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Entity Type | Individual
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Provider Name | MARILYN ROSE O'HARA L.I.S.W.
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Gender | Female
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Dates
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Enumeration Date | 02/20/2009
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Last Update Date | 02/20/2009
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Provider Practice Location Address
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Address Line | 27580 MOCCASIN ROAD
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City | LAURELVILLE
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State | OH
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Zip | 43135-0000
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Country | US
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Telephone | 740-332-4115
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 118
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City | LAURELVILLE
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State | OH
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Zip | 43135-0118
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Country | US
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Telephone | 740-332-4115
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | I-0004598
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License Number State | OH
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