Individual
RAYMOND J ODIORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
56 CHURCH ST, WATERBURY, CT 06702-2103
(203) 755-1196
(203) 575-9675
Mailing address
136 WOODSIDE AVE, WATERBURY, CT 06708-2504
Taxonomy
Speciality
Code
Description
License number
State
101YP1600X
Pastoral Counselor
Primary
000278
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ANTHEM
24000278CT04
CT
01
—
COMP CARE
ODIOR0010
CT
Enumeration date
09/07/2006
Last updated
07/08/2007
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