Provider Demographics
NPI:1215075536
Name:ODAY, JUDITH LOUISE (MA LPC)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:LOUISE
Last Name:ODAY
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:408 NORTH FOREST ST
Mailing Address - Street 2:
Mailing Address - City:JAMESPORT
Mailing Address - State:MO
Mailing Address - Zip Code:64648
Mailing Address - Country:US
Mailing Address - Phone:660-684-6497
Mailing Address - Fax:660-684-6497
Practice Address - Street 1:200 NORTH WILLIAMS ST
Practice Address - Street 2:
Practice Address - City:JAMESPORT
Practice Address - State:MO
Practice Address - Zip Code:64648
Practice Address - Country:US
Practice Address - Phone:660-684-6497
Practice Address - Fax:660-684-6497
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000492101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO33894011OtherBCBS