Provider Demographics
NPI:1023819224
Name:ODITA, JULIE (856) 249-0550 M
Entity type:Individual
Prefix:
First Name:JULIE (856) 249-0550
Middle Name:M
Last Name:ODITA
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:PO BOX 408
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08048-0408
Mailing Address - Country:US
Mailing Address - Phone:856-249-0550
Mailing Address - Fax:
Practice Address - Street 1:309 FELLOWSHIP RD STE 200-412
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-1234
Practice Address - Country:US
Practice Address - Phone:856-249-0550
Practice Address - Fax:888-588-2220
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-24
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach