Organization
JACQUELINE S ODOM PHD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE S ODOM PH.D. (PRESIDENT)
(248) 202-3367
Entity
Organization
Contact information
Practice address
30375 NORTHWESTERN HWY STE 200, FARMINGTON HILLS, MI 48334-3299
(248) 202-3367
(248) 254-3333
Mailing address
6250 GILBERT LAKE RD, BLOOMFIELD HILLS, MI 48301-1926
(248) 202-3367
(248) 254-3333
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
05/17/2012
Last updated
05/17/2012
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