Individual
MR. GERALD GENE ODOM SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3010 GRAND AVE, WAUKEGAN, IL 60085-2321
(284) 737-7868
(847) 377-8688
Mailing address
3010 GRAND AVE, WAUKEGAN, IL 60085-2321
(284) 737-7868
(847) 377-8688
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
IL
Other
Enumeration date
03/19/2012
Last updated
03/19/2012
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