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NPI Code Detail

MEDICARE: MISS FREIDA ODES M.S. CCC-SLP

MEDICARE: MISS FREIDA ODES M.S. CCC-SLP
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
1235Z00000XSpeech-Language Pathologist021904-1NY

General Provider Information

NPI Number : 1518275288
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS FREIDA ODES M.S. CCC-SLP
Provider Business Mailing Address
First Line : 7115 15TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11228-2105
Country : US
Telephone Number : 718-232-0685
Fax Number :
Provider Business Practice Location Address
First Line : 7115 15TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11228-2105
Country : US
Telephone Number : 718-232-0685
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2010
Last Update Date : 11/30/2016

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Directions to “ MISS FREIDA ODES M.S. CCC-SLP” Practice Location

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