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General NPI Number Information
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NPI Number | 1801339510
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Entity Type | Individual
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Provider Name | KATHRYN ELAINE ODEN PHD
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Gender | Female
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Dates
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Enumeration Date | 11/29/2016
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Last Update Date | 07/22/2019
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Provider Practice Location Address
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Address Line | 3128 HUDSON XING STE 1
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City | MCKINNEY
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State | TX
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Zip | 75070-6556
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Country | US
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Telephone | 469-252-7090
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Fax | 469-617-7052
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Provider Business Mailing Address
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Address Line | 1322 PONDEROSA PINE LN
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City | CARROLLTON
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State | TX
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Zip | 75007-1028
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Country | US
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Telephone | 214-274-0679
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Fax | 469-617-7052
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 26605
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License Number State | TX
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