Provider Demographics
NPI:1619794427
Name:ODAY, JASON CHRISTOPHER
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:CHRISTOPHER
Last Name:ODAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 COLDSPRING ROAD
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17222
Mailing Address - Country:US
Mailing Address - Phone:717-357-2857
Mailing Address - Fax:
Practice Address - Street 1:95 COLDSPRING RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:PA
Practice Address - Zip Code:17222-9701
Practice Address - Country:US
Practice Address - Phone:717-357-2857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health