Provider Demographics
NPI:1518692557
Name:O'DONNELL, LAINE
Entity Type:Individual
Prefix:
First Name:LAINE
Middle Name:
Last Name:O'DONNELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20949 MOREWOOD PKWY
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-1448
Mailing Address - Country:US
Mailing Address - Phone:614-214-2361
Mailing Address - Fax:
Practice Address - Street 1:20949 MOREWOOD PKWY
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-1448
Practice Address - Country:US
Practice Address - Phone:614-214-2361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-22
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor