Provider Demographics
NPI:1881220986
Name:OCONNELL, KATHARINE DUNSON (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATHARINE
Middle Name:DUNSON
Last Name:OCONNELL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 FOREST ST
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY HILLS
Mailing Address - State:MA
Mailing Address - Zip Code:02481-6832
Mailing Address - Country:US
Mailing Address - Phone:612-865-1294
Mailing Address - Fax:
Practice Address - Street 1:144 FOREST ST
Practice Address - Street 2:
Practice Address - City:WELLESLEY HILLS
Practice Address - State:MA
Practice Address - Zip Code:02481-6832
Practice Address - Country:US
Practice Address - Phone:612-865-1294
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-20
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP4024103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent