Individual
MARTHA M O'DANOVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
8300 BROADWAY, F1, MERRILLVILLE, IN 46410-8602
(219) 736-1000
(219) 736-9699
Mailing address
8300 BROADWAY, F1, MERRILLVILLE, IN 46410-8602
(219) 736-1000
(219) 736-9699
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
35000126A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200136790
—
IN
Enumeration date
09/16/2005
Last updated
08/28/2014
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