Provider Information for 1528816170
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MARY C O'DELL LICSW
Sex: Female
NPI: 1528816170
Last Updated: 2024-05-08
Certification Date: 2024-05-08
Certification Date: 2024-05-08
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1528816170 | ||||||||
| Enumeration Date | 2024-05-08 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1323 BIG OAK RD OHATCHEE, AL 36271-4030 United States Phone: 256-493-5522 | Fax: | ||||||||
| Primary Practice Address | 1323 BIG OAK RD OHATCHEE, AL 36271-4030 United States Phone: 256-493-5522 | Fax: | ||||||||
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