Provider Demographics
NPI:1184126435
Name:ODA, CHRISTINA (LSW)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:
Last Name:ODA
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7251 SAWMILL RD.
Mailing Address - Street 2:SUITE 150
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016
Mailing Address - Country:US
Mailing Address - Phone:614-766-0161
Mailing Address - Fax:614-766-0298
Practice Address - Street 1:1434 N. COURT ST.
Practice Address - Street 2:
Practice Address - City:CIRCLEVILLE
Practice Address - State:OH
Practice Address - Zip Code:43113
Practice Address - Country:US
Practice Address - Phone:614-766-0161
Practice Address - Fax:614-766-0298
Is Sole Proprietor?:No
Enumeration Date:2018-03-02
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.0800633101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health