Odaniel, Mary Anne E
Odaniel, Mary Anne E is an individual health care provider with primary practice located at 444 S Main St , Madisonville KY 42431. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Student, Health Care / Student in an Organized Health Care Education/Training Program. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is her primary health care specialty. Odaniel, Mary Anne E can be contacted via phone (270) 825-0069.Contact Information
Primary practice address
444 S Main St
Madisonville KY 42431
Phone: (270) 825-0069
Fax: (270) 824-9777
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 007430 | Kentucky |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | TP2018037 | Kentucky |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X |
Profile Details
| NPI number | 1578052171 |
|---|---|
| LBN Legal business name | Odaniel, Mary Anne E |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 9th, 2018 |
| Last updated | Mar 6th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578052171 | NPPES |
| Kentucky | MEDICAID | 7100552180 |
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