Provider Demographics
NPI:1881826865
Name:O'DONNELL, EMILY A (OT)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:A
Last Name:O'DONNELL
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MS
Other - First Name:EMILY
Other - Middle Name:A
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:710 RABON RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-8903
Mailing Address - Country:US
Mailing Address - Phone:803-419-1777
Mailing Address - Fax:803-419-4777
Practice Address - Street 1:1732 VILLAGE PARK DR
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29118-2457
Practice Address - Country:US
Practice Address - Phone:803-534-2251
Practice Address - Fax:803-534-7636
Is Sole Proprietor?:No
Enumeration Date:2009-08-10
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3499225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist