Individual
ROBERT WAYNE ODEGAARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LADC
Contact information
Practice address
7616 CURRELL BLVD, WOODBURY, MN 55125-2290
(651) 259-9750
(651) 259-9790
Mailing address
7616 CURRELL BLVD, WOODBURY, MN 55125-2290
(651) 259-9750
(651) 259-9790
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
301997
MN
Other
Enumeration date
10/12/2007
Last updated
10/12/2007
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