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NPI Code Detail

MEDICARE: ALLISON ODDI

MEDICARE: ALLISON ODDI
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
1235Z00000XSpeech-Language Pathologist30000649NC

General Provider Information

NPI Number : 1720727456
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLISON ODDI
Provider Business Mailing Address
First Line : 856 OLD FOLKSTONE RD
Second Line :
City : SNEADS FERRY
State : NC
Zip : 28460-9436
Country : US
Telephone Number : 724-705-5466
Fax Number :
Provider Business Practice Location Address
First Line : 1839 ONSLOW DR
Second Line :
City : JACKSONVILLE
State : NC
Zip : 28540-5906
Country : US
Telephone Number : 910-455-3610
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2022
Last Update Date : 06/01/2022

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Directions to “ ALLISON ODDI ” Practice Location

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