Organization
FATIMA ODETALLA, NP IN PSYCHIATRY, PLLC
Active
Other names
Lighthouse Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FATIMA ODETALLA DNP, APRN (OWNER)
(901) 590-7680
Entity
Organization
Contact information
Practice address
99 MAIN ST STE 302, NYACK, NY 10960-3109
(901) 590-7680
Mailing address
65 E MALTBIE AVE, SUFFERN, NY 10901-6007
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/13/2020
Last updated
11/13/2020
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