Provider Demographics
NPI:1083344147
Name:O'DONNELL, ERIN MARIE
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:MARIE
Last Name:O'DONNELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2370 BRUCE B DOWNS BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-9215
Mailing Address - Country:US
Mailing Address - Phone:813-592-8029
Mailing Address - Fax:
Practice Address - Street 1:2370 BRUCE B DOWNS BLVD STE 300
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-9215
Practice Address - Country:US
Practice Address - Phone:813-592-8029
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI50402355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSI5040OtherSTATE LICENSE