Provider Demographics
NPI:1497837041
Name:O'DOWD, WILLIAM THOMAS (PHD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:THOMAS
Last Name:O'DOWD
Suffix:
Gender:M
Credentials:PHD
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Mailing Address - Street 1:2720 W 43RD ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55410-1643
Mailing Address - Country:US
Mailing Address - Phone:612-865-0048
Mailing Address - Fax:612-925-4867
Practice Address - Street 1:2720 W 43RD ST
Practice Address - Street 2:SUITE 205
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55410-1643
Practice Address - Country:US
Practice Address - Phone:612-865-0048
Practice Address - Fax:612-925-4867
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MNLP1276103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist