Individual
GRACIE ODE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, BHC
Contact information
Practice address
1601 SIOUX VALLEY DR, LUVERNE, MN 56156-4500
(507) 283-4476
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
32473
MN
104100000X
Social Worker
32473
MN
Other
Enumeration date
09/12/2023
Last updated
09/26/2023
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