Basic Information
| Provider Information | |||||||||
| NPI: | 1578012001 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | O'BRIEN | ||||||||
| FirstName: | RAEANNA | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | LPCC-S | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3645 RIDGE MILL DR | ||||||||
| Address2: | |||||||||
| City: | HILLIARD | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430267752 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6144577876 | ||||||||
| FaxNumber: | 6144577896 | ||||||||
| Practice Location | |||||||||
| Address1: | 299 CRAMER CREEK CT. | ||||||||
| Address2: | |||||||||
| City: | DUBLIN | ||||||||
| State: | OH | ||||||||
| PostalCode: | 430172586 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6148895722 | ||||||||
| FaxNumber: | 6144571040 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/26/2016 | ||||||||
| LastUpdateDate: | 12/09/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | E.0007882 | OH | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.