Individual
MRS. JACQUELINE ODUSELU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, NCC, LPC, CPCS
Contact information
Practice address
1827 BRACKENDALE RD NW, KENNESAW, GA 30152-7747
(678) 582-1469
(770) 212-2210
Mailing address
1827 BRACKENDALE RD NW, KENNESAW, GA 30152-7747
(678) 582-1469
(770) 212-2210
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
LPC008829
GA
101YM0800X
Mental Health Counselor
LPC008829
GA
101YP1600X
Pastoral Counselor
LPC008829
GA
101YP2500X
Professional Counselor
Primary
LPC008829
GA
Other
Enumeration date
02/12/2016
Last updated
06/22/2024
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