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NPI Code Detail

MEDICARE: MARIAL ODETTE

MEDICARE: MARIAL ODETTE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1003466491
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIAL ODETTE
Provider Business Mailing Address
First Line : 21600 OXNARD ST STE 1800
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-7807
Country : US
Telephone Number : 818-345-2345
Fax Number :
Provider Business Practice Location Address
First Line : 601 W 1ST AVE STE 1400
Second Line :
City : SPOKANE
State : WA
Zip : 99201-3813
Country : US
Telephone Number : 509-570-7453
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2019
Last Update Date : 09/17/2019

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Directions to “ MARIAL ODETTE ” Practice Location

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