Fredrick Odongo
Nurse Practitioner, Psych/Mental Health in Arlington, TX. Individual provider (NPI-1).
NPI number1104582006
StatusActive
Last updated in NPPESNov 15, 2021
Details
- NPI
- 1104582006
- Entity type
- Individual (NPI-1)
- Name
- Fredrick Odongo
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Nov 15, 2021
- Certification date
- Nov 15, 2021
- Last updated
- Nov 15, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | 1051796 | TX | Yes |
Practice location
715 N Fielder RdArlington, TX 76012-4695
Phone 817-962-0409
Mailing address
8206 Ithaca DrArlington, TX 76002-4423
Phone 817-412-3406
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