Individual
DR. PAGE ODOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D
Contact information
Practice address
8288 TELEGRAPH RD, SUITE A, ODENTON, MD 21113-1130
(410) 305-0158
(410) 305-0159
Mailing address
8288 TELEGRAPH RD, SUITE A, ODENTON, MD 21113-1130
(410) 305-0158
(410) 305-0159
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
04143
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11833482
CAQH
MD
Enumeration date
07/09/2008
Last updated
07/09/2008
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