Odell, Tanya Marie

Odell, Tanya Marie is an sole proprietor health care provider with primary practice located at 7969 Ashton Ave , Manassas VA 20109-2885. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Odell, Tanya Marie can be contacted via phone (703) 792-7800.

Contact Information

Primary practice address
7969 Ashton Ave Manassas VA 20109-2885
Phone: (703) 792-7800
Fax: (703) 792-5699
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 0701003436 Virginia

Profile Details

NPI number 1245397439
LBN Legal business name Odell, Tanya Marie
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 3rd, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245397439 NPPES
Virginia Other 288973 BLUE CROSS BLUE SHIELD
Virginia Other 292740 BLUE CROSS BLUE SHIELD
Virginia MEDICAID 4945247 BLUE CROSS BLUE SHIELD

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