Provider Demographics
NPI:1407188972
Name:ODEN, BECKY FRIESLAND (MMFT)
Entity Type:Individual
Prefix:
First Name:BECKY
Middle Name:FRIESLAND
Last Name:ODEN
Suffix:
Gender:F
Credentials:MMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:337 THOMAS DR
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-3742
Mailing Address - Country:US
Mailing Address - Phone:469-261-4948
Mailing Address - Fax:
Practice Address - Street 1:1400 PRESTON RD
Practice Address - Street 2:SUITE 400
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5186
Practice Address - Country:US
Practice Address - Phone:469-261-4948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-08
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX17367101YP2500X
TX5091106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist