Provider Demographics
NPI:1811059454
Name:ODLAND, PAULA JOYELLE (LMFT)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:JOYELLE
Last Name:ODLAND
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1210 BROADWAY ST.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308
Mailing Address - Country:US
Mailing Address - Phone:320-491-2303
Mailing Address - Fax:320-762-6541
Practice Address - Street 1:1210 BROADWAY ST.
Practice Address - Street 2:SUITE 200
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308
Practice Address - Country:US
Practice Address - Phone:320-491-2303
Practice Address - Fax:320-762-6541
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1361106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist