Individual
TERESSA GAYLE O'DANIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
03/07/2007
Contact information
Practice address
1093 NARROW GAUGE CT, WINTER GARDEN, FL 34787-2124
(407) 656-0362
Mailing address
1093 NARROW GAUGE CT, WINTER GARDEN, FL 34787-2124
(407) 656-0362
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
OTA5830
FL
Other
Enumeration date
11/24/2008
Last updated
11/24/2008
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