MEDICARE: NAOMI ODAI-ANIM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide		DC

General Provider Information

NPI Number	:	1588929103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAOMI ODAI-ANIM

Provider Business Mailing Address
First Line	:	5203 ASHLEIGH GLEN CT
Second Line	:	GLENDALE
City	:	GLENN DALE
State	:	MD
Zip	:	20769-9148
Country	:	US
Telephone Number	:	301-357-2664
Fax Number	:

Provider Business Practice Location Address
First Line	:	5203 ASHLEIGH GLEN CT
Second Line	:	GLENDALE
City	:	GLENN DALE
State	:	MD
Zip	:	20769-9148
Country	:	US
Telephone Number	:	301-357-2664
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2012
Last Update Date	:	07/10/2012

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Directions to “ NAOMI ODAI-ANIM ” Practice Location

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