Provider Demographics
NPI:1376216465
Name:ODABASHIAN, BRIDGETTE
Entity Type:Individual
Prefix:
First Name:BRIDGETTE
Middle Name:
Last Name:ODABASHIAN
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 1:21909 COUNTRY WAY
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44149-9223
Mailing Address - Country:US
Mailing Address - Phone:216-956-1332
Mailing Address - Fax:
Practice Address - Street 1:970 SUMNER PKWY
Practice Address - Street 2:
Practice Address - City:COPLEY
Practice Address - State:OH
Practice Address - Zip Code:44321-1693
Practice Address - Country:US
Practice Address - Phone:330-664-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist