Individual
DEBORAH A ODOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
222 E MAIN ST # 117, BARSTOW, CA 92311-2361
(760) 255-1496
(760) 255-2542
Mailing address
222 E MAIN ST STE 117, BARSTOW, CA 92311-2361
(760) 255-1496
(760) 255-2542
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5401
SIMON STAFF NUMBER
CA
Enumeration date
05/22/2007
Last updated
08/09/2023
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