Provider Demographics
NPI:1326147208
Name:O'CONNER, PATRICK WILLIAM (PHD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:WILLIAM
Last Name:O'CONNER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:146 WEST DALE ST
Mailing Address - Street 2:STE 101
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50644
Mailing Address - Country:US
Mailing Address - Phone:319-233-3351
Mailing Address - Fax:319-235-3132
Practice Address - Street 1:146 W DALE ST
Practice Address - Street 2:STE 101
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50703-1901
Practice Address - Country:US
Practice Address - Phone:319-233-3351
Practice Address - Fax:319-235-3132
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA00530103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical