Odom-Mack, Shalanda M

Odom-Mack, Shalanda M is an sole proprietor health care provider with primary practice located at 11305 Keppler Ct , Cleveland OH 44105-6242. She recently has only one registered license in Nursing Service Related Providers / Nurse's Aide, which is considered as her primary health care specialty. Odom-Mack, Shalanda M can be contacted via phone (216) 801-2700.

Contact Information

Primary practice address
11305 Keppler Ct Cleveland OH 44105-6242
Phone: (216) 801-2700
Fax: (216) 801-2700
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Nurse's Aide 376K00000X 376939251197 Ohio

Profile Details

NPI number 1336351634
LBN Legal business name Odom-Mack, Shalanda M
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 7th, 2007
Last updated May 23rd, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336351634 NPPES
Ohio MEDICAID 2365435

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