Individual
KRISTEN H O'DELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12 MADISON AVE, BLASDELL, NY 14219-1716
(908) 894-9054
Mailing address
12 MADISON AVE, BLASDELL, NY 14219-1716
(908) 894-9054
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86008465
NY
Other
Enumeration date
07/08/2019
Last updated
07/08/2019
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