Doctor Name: | JAIME ODELL |
NPI Number: | 1265687586 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SPEECH LANGUAGE PATH |
License Number: | 12064709 |
Business Practice Address: | 49664 Gratiot Ave Chesterfield, MI - 480512526 |
Business Phone Number: | 5864356942 |
Business Fax Number: | 5864352331 |
Mailing Address: | 49664 Gratiot Ave, CHESTERFIELD |
State: | MI |
Postal Code: | 480512526 |
Phone Number: | 5864356942 |
Fax Number: | 5864352331 |
NPI Enumeration Date: | 12/01/2008 |
NPI Last Update Date: | 12/01/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 12064709 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |