| Provider / Organization | NPI | Date Certified |
|---|---|---|
| COBY K ODATE | 1033972203 | 2024-11-10 |
Coby K Odate is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1033972203. Registration indicates Coby K Odate is a provider of services with a specialization in Behavioral Health & Social Service Providers, Behavior Technician (Behavior Technician, Behavioral Health & Social Service Providers) (Behavior Technician, )
| Entity Type | Individual |
| Provider Name | Coby K Odate |
| Practice Office Address | 1000 E PARIS AVE SE GRAND RAPIDS, MI US |
| Practice Office Telephone | 8442441818 |
| Mailing Address | 7108 S KANNER HWY STUART, FL 349977462 US |
| Business Telephone | 3474039694 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 400 E Pratt St Fl 8 | Baltimore, MD 212023180 | 8558326727 |
| Code | Practice | License No State |
|---|---|---|
| 106S00000X PRIMARY | Behavioral Health & Social Service Providers Behavior Technician Behavior Technician Behavioral Health & Social Service Providers Behavior Technician |