Individual
KENDALL GRACE ODOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
240 RINGGOLD RD, CLARKSVILLE, TN 37042-3469
(931) 648-5625
Mailing address
1975 COUNTRY VW, CHAPMANSBORO, TN 37035-5215
(615) 840-1606
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4298
TN
Other
Enumeration date
10/30/2025
Last updated
10/30/2025
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