Individual
JUSTINA MARIE O'DONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1620 OLD EAGLEVILLE ROAD, TIVERTON, RI 02878
(401) 624-7324
Mailing address
1620 EAGLEVILLE RD, TIVERTON, RI 02878-2902
(401) 624-7324
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA00098
RI
Other
Enumeration date
03/22/2007
Last updated
07/08/2007
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