Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | R119113 | MD |
NPI | 1023486263 |
---|---|
Provider Name | Joy C Odinammadu |
First Address | Catonsville, MD 21228-2452 |
Second Address | Catonsville, MD 21228-2452 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2015 |
Last Update Date | 03/09/2015 |