MEDICARE: GRACE ODIGIE

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
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1699614255
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRACE ODIGIE

Provider Business Mailing Address
First Line	:	316 W BROADWAY RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85041-0060
Country	:	US
Telephone Number	:	623-275-6473
Fax Number	:

Provider Business Practice Location Address
First Line	:	316 W BROADWAY RD
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85041-0060
Country	:	US
Telephone Number	:	623-275-6473
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2026
Last Update Date	:	03/27/2026

Similar Medicare Providers

1013529353 — CAROLYN AMES DNP, AGACNP-BC
Practice Location Address:

25111 N 21ST AVE UNIT 147
PHOENIX, AZ
85085-0060

Practice Phone: 507-272-9510
Practice Fax:

1093654824 — MARIE HORTENSE TIOKOU PMHNP
Practice Location Address:

6812 S 21ST DR
PHOENIX, AZ
85041-6561

Practice Phone: 480-284-9638
Practice Fax: 602-429-8148

1326987918 — AMELIA YOUNG
Practice Location Address:

234 W SOUTHERN AVE
PHOENIX, AZ
85041-4845

Practice Phone: 480-547-6942
Practice Fax:

1952249195 — SOUTHERN DENTAL LLC
Practice Location Address:

3320 W SOUTHERN AVE STE 111
PHOENIX, AZ
85041-4307

Practice Phone: 630-699-3744
Practice Fax:

1295680353 — SOPHIA CORETTA GRAVES
Practice Location Address:

2432 W PARKWAY DR
PHOENIX, AZ
85041-2031

Practice Phone: 602-875-1324
Practice Fax:

1437970803 — CARESTAR LLC
Practice Location Address:

2030 W BASELINE RD # 182-1551
PHOENIX, AZ
85041-6574

Practice Phone: 480-559-9999
Practice Fax:

Directions to “ GRACE ODIGIE ” Practice Location

Language	Start Address	Practice Location

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.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.