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Individual

MICHAEL RYAN ODLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
SCHOOL PSYCHOLOGIST

Contact information

Practice address
36716 OAK POINT RD, SPRINGFIELD, OR 97478
(541) 255-8463
Mailing address
36716 OAK POINT RD, SPRINGFIELD, OR 97478
(541) 255-8463

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
10478961
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
22667
ACE-AMERICAN INSURANCE COMPANY
OR
Enumeration date
03/01/2018
Last updated
03/01/2018
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