Provider Demographics
NPI:1518192301
Name:O'DANIEL, ANNMARIE (LPC)
Entity Type:Individual
Prefix:MS
First Name:ANNMARIE
Middle Name:
Last Name:O'DANIEL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5141 SW MEADOW FLOWER DR
Mailing Address - Street 2:
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97333-1185
Mailing Address - Country:US
Mailing Address - Phone:541-829-2580
Mailing Address - Fax:
Practice Address - Street 1:230 SW 3RD ST STE 211
Practice Address - Street 2:
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97333-4656
Practice Address - Country:US
Practice Address - Phone:541-829-2580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-21
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC2654101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor