Provider Demographics
NPI:1346000684
Name:ODHIAMBO, BETTY AKINYI
Entity Type:Individual
Prefix:
First Name:BETTY
Middle Name:AKINYI
Last Name:ODHIAMBO
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 1:306 NORTHEAST AVE APT D105
Mailing Address - Street 2:
Mailing Address - City:TALLMADGE
Mailing Address - State:OH
Mailing Address - Zip Code:44278-1471
Mailing Address - Country:US
Mailing Address - Phone:913-850-3224
Mailing Address - Fax:
Practice Address - Street 1:306 NORTHEAST AVE APT D105
Practice Address - Street 2:
Practice Address - City:TALLMADGE
Practice Address - State:OH
Practice Address - Zip Code:44278-1471
Practice Address - Country:US
Practice Address - Phone:913-850-3224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker