Organization
ASPEN FAMILY CENTER OF ALABAMA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANYA MARIE ODANIEL LCSW (DIRECTOR)
(937) 726-8629
Entity
Organization
Contact information
Practice address
336 RICHMAR DR, MOUNTAIN BRK, AL 35213-4418
(937) 726-8629
Mailing address
336 RICHMAR DR, MOUNTAIN BRK, AL 35213-4418
(937) 726-8629
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3623C
AL
Other
Enumeration date
12/15/2014
Last updated
12/15/2014
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