Individual
KIMBERLY ODENDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
10631 S 51ST ST, SUITE 8, PHOENIX, AZ 85044-5225
(480) 398-4280
Mailing address
4646 E LEWIS AVE, PHOENIX, AZ 85008-2406
(602) 472-6876
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
6194
AZ
Other
Enumeration date
10/29/2015
Last updated
10/29/2015
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