| Ellen L Odom, Llc | |
|
5700 Regency Ct S Mobile AL 36609-3277 | |
| (251) 379-9434 | |
| Not Available |
| Full Name | Ellen L Odom, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5700 Regency Ct S, Mobile, Alabama |
| Authorized Official Name and Position | Ellen Odom (LICENSED PROFESSIONAL COUNSELOR) |
| Authorized Official Contact | 2513799434 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellen L Odom, Llc 5700 Regency Ct S Mobile AL 36609-3277 Ph: (251) 379-9434 | Ellen L Odom, Llc 5700 Regency Ct S Mobile AL 36609-3277 Ph: (251) 379-9434 |
| NPI Number | 1497473870 |
|---|---|
| Provider Enumeration Date | 08/22/2022 |
| Last Update Date | 08/22/2022 |
| Certification Date | 08/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497473870 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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