Individual
MISS SHIVONNE A ODOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
306 ATLANTIC ST SE, #3, WASHINGTON, DC 20032-3098
(508) 272-6348
Mailing address
306 ATLANTIC ST SE, #3, WASHINGTON, DC 20032-3098
(508) 272-6348
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
PRC14590
DC
101YP2500X
Professional Counselor
Primary
LC3868
MD
Other
Enumeration date
03/29/2011
Last updated
11/03/2016
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