Individual
SAMUEL ODOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, MSW, LGSW
Contact information
Practice address
1585 3RD ST, FORT POLK, LA 71459-5102
(337) 531-3922
Mailing address
7541 PARRY ST, NEW ORLEANS, LA 70128-1266
(504) 430-6287
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
5089
LA
Other
Enumeration date
03/20/2007
Last updated
07/08/2007
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