Individual
BETHANY GRACE ODOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
405 S SEAMAN ST, EASTLAND, TX 76448-2749
(254) 629-3355
Mailing address
405 S SEAMAN ST, EASTLAND, TX 76448-2749
(254) 629-3355
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
88752
TX
Other
Enumeration date
06/02/2022
Last updated
06/02/2022
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