Ezra Odioko
Social Worker, Clinical in Grand Rapids, MI. Individual provider (NPI-1).
NPI number1932789286
StatusActive
Last updated in NPPESJan 15, 2025
Details
- NPI
- 1932789286
- Entity type
- Individual (NPI-1)
- Name
- Ezra Odioko
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 12, 2021
- Certification date
- Jul 9, 2024
- Last updated
- Jan 15, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 6851108588 | MI | Yes |
| 104100000X | Social Worker | – | – |
Practice location
1939 Division Ave SGrand Rapids, MI 49507
Phone 616-247-3815 · Fax 616-245-0450
Mailing address
1939 Division Ave SGrand Rapids, MI 49507
Phone 616-247-3815 · Fax 616-245-0450
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