Individual
ASHLEY ODOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5003 WINTER GARDEN PKWY, FORT PIERCE, FL 34951-2031
(772) 207-0566
Mailing address
5003 WINTER GARDEN PKWY, FORT PIERCE, FL 34951-2031
(772) 207-0566
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
813994458
FL
Other
Enumeration date
11/29/2016
Last updated
11/29/2016
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