Provider Demographics
NPI:1548070600
Name:ODDO, BRIANA D
Entity type:Individual
Prefix:
First Name:BRIANA
Middle Name:D
Last Name:ODDO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 N MANGUM ST APT 223
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-4924
Mailing Address - Country:US
Mailing Address - Phone:214-310-8988
Mailing Address - Fax:
Practice Address - Street 1:1921 N POINTE DR STE 280
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2689
Practice Address - Country:US
Practice Address - Phone:984-204-1351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-10
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCPO214051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical