Provider Demographics
NPI:1073746095
Name:O'CONNOR, ERIN G (PHD, LP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:G
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:PHD, LP
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:G
Other - Last Name:SHEPPARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD, LP
Mailing Address - Street 1:5173 PINE LAKE FOREST CT
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:MI
Mailing Address - Zip Code:48451-9020
Mailing Address - Country:US
Mailing Address - Phone:248-494-1016
Mailing Address - Fax:
Practice Address - Street 1:G3230 BEECHER RD
Practice Address - Street 2:SUITE 1
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48532-3604
Practice Address - Country:US
Practice Address - Phone:810-342-5656
Practice Address - Fax:810-342-5600
Is Sole Proprietor?:No
Enumeration Date:2009-08-25
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301013999103TC0700X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical