Provider Demographics
NPI:1043668429
Name:LORIN ODONNELL
Entity Type:Organization
Organization Name:LORIN ODONNELL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MFT
Authorized Official - Prefix:
Authorized Official - First Name:LORIN
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:ODONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:310-748-4511
Mailing Address - Street 1:732 W 9TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:SAN PEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:90731-3638
Mailing Address - Country:US
Mailing Address - Phone:310-748-4511
Mailing Address - Fax:
Practice Address - Street 1:732 W 9TH ST STE 201
Practice Address - Street 2:
Practice Address - City:SAN PEDRO
Practice Address - State:CA
Practice Address - Zip Code:90731-3638
Practice Address - Country:US
Practice Address - Phone:310-748-4511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-26
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty