Individual
MRS. JANET ODELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
137 WINCKLES STREET, ELYRIA, OH 44035
(440) 366-5993
(440) 366-5313
Mailing address
137 WINCKLES STREET, ELYRIA, OH 44035
(440) 366-5993
(440) 366-5313
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT01853
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000132805
ANTHEM BCBS
OH
05
—
2167462
—
OH
01
—
341490517041
CARE SOURCE
OH
01
—
654140
AETNA
OH
Enumeration date
04/07/2006
Last updated
07/08/2007
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