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General NPI Number Information
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NPI Number | 1932241973
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Entity Type | Individual
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Provider Name | ANNETTE CAMERON O'CONNELL M.S., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 06/13/2013
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Provider Practice Location Address
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Address Line | 110 TRADING BAY DR SUITE 105
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City | KENAI
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State | AK
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Zip | 99611-7716
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Country | US
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Telephone | 907-283-4300
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Fax | 907-283-4362
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Provider Business Mailing Address
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Address Line | PO BOX 3187
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City | KENAI
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State | AK
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Zip | 99611-3187
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Country | US
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Telephone | 907-283-4300
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Fax | 907-283-4362
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 63
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License Number State | AK
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