Individual
MS. LAURA ELLEN O'DELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2216 N BLUE MILLS RD, INDEPENDENCE, MO 64058-2019
(816) 778-1696
Mailing address
PO BOX 2138, INDEPENDENCE, MO 64055-0038
(816) 778-1696
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
MT112495
TX
Other
Enumeration date
09/13/2012
Last updated
09/13/2012
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