Individual
AMBER R ODOM-SULLIVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
202 S WASHITA AVE, WYNNEWOOD, OK 73098-7820
(405) 665-4385
Mailing address
1420 E JENNINGS ST, WYNNEWOOD, OK 73098-1020
(405) 207-8510
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/10/2021
Last updated
02/10/2021
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