Individual
CALLIE MARIE ODONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12 EVERGREEN DR, JERMYN, PA 18433-1130
(570) 840-8356
Mailing address
12 EVERGREEN DR, JERMYN, PA 18433-1130
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OC017758
PA
Other
Enumeration date
06/23/2021
Last updated
06/23/2021
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