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Individual

MIKENNA MARIE O'DONNELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
202 S 4TH ST W, BAKER, MT 59313-9156
(406) 778-3331
(406) 778-5163
Mailing address
PO BOX 1015, BAKER, MT 59313-1015
(406) 702-5026

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTP-OT-LIC-6625
MT

Other

Enumeration date
03/01/2019
Last updated
03/01/2019
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