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Individual

ODIS MCKINZIE JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCPC

Contact information

Practice address
45-329 PUALI ST, KANEOHE, HI 96744-2241
(240) 601-5272
(301) 682-5326
Mailing address
45-329 PUALI ST, KANEOHE, HI 96744-2241
(240) 601-5272

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0701003945
VA
101YM0800X
Mental Health Counselor
Primary
MHC 242
HI

Other

Enumeration date
01/08/2007
Last updated
05/02/2011
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