Individual
ETHEL ODON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
336 CALUMET LN, DAYTON, OH 45417-8010
(937) 248-1857
Mailing address
336 CALUMET LN, DAYTON, OH 45417-8010
(937) 248-1857
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
—
251X00000X
Supports Brokerage Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
374U00000X
Home Health Aide
—
—
376J00000X
Homemaker
Primary
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
08/23/2022
Last updated
08/23/2022
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