Individual
AMY MARIE ODIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
909 REINLI ST APT 133, AUSTIN, TX 78751-1509
(832) 279-4035
Mailing address
PO BOX 4511, WHITEFISH, MT 59937-4511
(832) 279-4035
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
60952
TX
1041C0700X
Clinical Social Worker
BBH-LCSW-LIC-37865
MT
1041C0700X
Clinical Social Worker
C-115021
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60952
LCSW-S
TX
01
—
BBH-LCSW-LIC-37865
LCSW
MT
01
—
C-115021
LCSW
NM
Enumeration date
12/02/2019
Last updated
10/04/2022
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