Individual
ODELL DENNIS FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14 S BROADWAY, BALTIMORE, MD 21231-1712
(410) 276-1773
(410) 276-2056
Mailing address
14 S BROADWAY, BALTIMORE, MD 21231-1712
(410) 276-1773
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ADT1412
MD
Other
Enumeration date
08/07/2017
Last updated
08/07/2017
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