Individual
SAMANTHA ODOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
9559 HIGHWAY 5 STE 601, DOUGLASVILLE, GA 30135-1572
(470) 632-5276
(317) 520-8200
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-58690
GA
Other
Enumeration date
03/25/2022
Last updated
02/22/2024
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