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NPI Code Detail

MEDICARE: AUBREY ODEFEY

MEDICARE: AUBREY ODEFEY
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
1171M00000XCase Manager/Care CoordinatorF25-118131UT
2106S00000XBehavior Technician
3390200000XStudent in an Organized Health Care Education/Training Program0UT

General Provider Information

NPI Number : 1578138194
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUBREY ODEFEY
Provider Business Mailing Address
First Line : 3725 W 4100 S STE 201
Second Line :
City : WEST VALLEY CITY
State : UT
Zip : 84120-6490
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6856 S 700 E
Second Line :
City : MIDVALE
State : UT
Zip : 84047-1361
Country : US
Telephone Number : 888-949-4864
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2021
Last Update Date : 08/19/2025

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Directions to “ AUBREY ODEFEY ” Practice Location

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