Individual
JACQUELINE S ODOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
4949 COOLIDGE HWY, ROYAL OAK, MI 48073-1026
(248) 655-5900
(248) 655-5901
Mailing address
6250 GILBERT LAKE RD, BLOOMFIELD HILLS, MI 48301-1926
(248) 645-1231
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
JO010213
MI
Other
Enumeration date
11/07/2006
Last updated
07/08/2007
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