Individual
DEBORAH L ODOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BS
Contact information
Practice address
422 N MAIN ST, WARSAW, NY 14569-1023
(585) 786-8133
(585) 786-9928
Mailing address
PO BOX 204, PAVILION, NY 14525-0204
(585) 584-3925
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00740423
—
NY
Enumeration date
10/01/2007
Last updated
10/01/2007
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