Individual
KOUSALYA ODOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
9940 ALVATON RD, ALVATON, KY 42122-9657
(270) 702-8970
Mailing address
1111 TEAL ST, BOWLING GREEN, KY 42104-7229
(270) 202-7525
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
01/14/2016
Last updated
03/17/2021
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