Provider Information for 1932691367
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MICHAEL P O'BRIEN LSW, CDCA
Sex: Male
NPI: 1932691367
Last Updated: 2024-09-23
Certification Date: 2024-09-23
Certification Date: 2024-09-23
Details
| Name | Value | ||||||||||||||||
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| NPI | 1932691367 | ||||||||||||||||
| Enumeration Date | 2018-06-01 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 527 N MERIDIAN RD YOUNGSTOWN, OH 44509-1227 United States Phone: 330-797-0070 | Fax: | ||||||||||||||||
| Primary Practice Address | 527 N MERIDIAN RD YOUNGSTOWN, OH 44509-1227 United States Phone: 330-797-0070 | Fax: | ||||||||||||||||
| Secondary Practice Address(es) | 550 W CHALMERS AVE | ||||||||||||||||
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