Individual
MRS. CLAIRE EDEN ODAKURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2089 TERON TRCE, SUITE 120, DACULA, GA 30019-1609
(770) 904-6009
Mailing address
2089 TERON TRCE, SUITE 120, DACULA, GA 30019-1609
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OT005810
GA
225XP0200X
Pediatric Occupational Therapist
Primary
OT005810
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003147296C
—
GA
Enumeration date
05/05/2014
Last updated
01/06/2016
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