Individual
RICHARD ODOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
213 E 2ND ST, FAIRMONT, MN 56031-2814
(507) 236-1889
Mailing address
213 E 2ND ST, FAIRMONT, MN 56031-2814
(507) 236-1889
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
302138
MN
101YM0800X
Mental Health Counselor
Primary
2346
MN
Other
Enumeration date
10/13/2019
Last updated
10/13/2019
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