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Individual

MR. ANYA ONUOHA ODIM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3500 WESTGATE DR, SUITE 604, DURHAM, NC 27707-2567
(919) 451-6337
(919) 484-1125
Mailing address
4520 SHADY SIDE LN, DURHAM, NC 27713-3127
(919) 451-6337
(919) 484-1125

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
2596
NC
103TB0200X
Cognitive & Behavioral Psychologist
2596
NC
103TC0700X
Clinical Psychologist
Primary
2596
NC
103TC2200X
Clinical Child & Adolescent Psychologist
2596
NC
103TH0100X
Health Service Psychologist
2596
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6107416
NC
Enumeration date
11/20/2006
Last updated
08/21/2013
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