Provider Demographics
NPI:1285231688
Name:ODDO, ALYSSA (MSW)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:ODDO
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2011 GLADSTONE DR
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-5825
Mailing Address - Country:US
Mailing Address - Phone:630-664-7332
Mailing Address - Fax:
Practice Address - Street 1:2011 GLADSTONE DR
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189-5825
Practice Address - Country:US
Practice Address - Phone:630-664-7332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-08
Last Update Date:2020-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker