Individual
ELLEN ODOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., L.P.C.
Contact information
Practice address
5700 REGENCY CT S, MOBILE, AL 36609-3277
(251) 379-9434
Mailing address
5700 REGENCY CT S, MOBILE, AL 36609-3277
(251) 379-9434
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
1896
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
515 45863
BLUE CROSS BLUE SHIELD
AL
Enumeration date
07/12/2006
Last updated
04/23/2022
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