KYLE BRENT ODESHA

MEDFORD, OR
NPI1023621950
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy171M00000X Case Manager/Care Coordinator
Additional Taxonomies101YM0800X Counselor, Mental Health
172V00000X Community Health Worker
Enumeration Date2020-08-29
Last Update Date2023-12-29
Business Address
KYLE BRENT ODESHA
200 BEATTY ST
MEDFORD, OR 97501-5811
Phone number: 541-476-2373
Mailing Address
KYLE BRENT ODESHA
1215 SW G ST
GRANTS PASS, OR 97526-2544
Phone number: 541-476-2373