Individual
MELISSA ODOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3030 NORTHERN BLVD STE 108, LONG ISLAND CITY, NY 11101-2812
(646) 812-7117
Mailing address
3030 NORTHERN BLVD STE 108, LONG ISLAND CITY, NY 11101-2812
Taxonomy
Speciality
Code
Description
License number
State
163WI0500X
Infusion Therapy Registered Nurse
666765
NY
171400000X
Health & Wellness Coach
Primary
666765
NY
Other
Enumeration date
06/11/2020
Last updated
04/25/2023
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