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Individual

STEPHANIE ODAFFER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
7822 HEDGEHOP DR, ZIONSVILLE, IN 46077-9835
(317) 405-9016
Mailing address
7822 HEDGEHOP DR, ZIONSVILLE, IN 46077-9835
(317) 405-9016

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22005022A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
22005022A
INDIANA SPEECH LICENSE
IN
Enumeration date
06/30/2014
Last updated
06/30/2014
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