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NPI Code Detail

MEDICARE: ISIEOMA RAY ODOR

MEDICARE: ISIEOMA RAY ODOR
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
1106H00000XMarriage & Family TherapistMN

General Provider Information

NPI Number : 1346128535
Entity Type Code : Individual
Provider Name (Legal Business Name) : ISIEOMA RAY ODOR
Provider Business Mailing Address
First Line : 8100 EMERSON AVE S UNIT 507
Second Line :
City : BLOOMINGTON
State : MN
Zip : 55420-1051
Country : US
Telephone Number : 952-486-3369
Fax Number :
Provider Business Practice Location Address
First Line : 1206 42ND AVE N
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55412-1611
Country : US
Telephone Number : 612-824-3369
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2025
Last Update Date : 08/25/2025

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Directions to “ ISIEOMA RAY ODOR ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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