Individual
LESLIE M ODOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., CCC-SLP
Contact information
Practice address
2411 WESTGATE DR, ALBANY, GA 31707-2225
(229) 461-5926
Mailing address
847 MURPHY RD, DAWSON, GA 39842-4126
(229) 881-3037
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP006243
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
795771487B
—
GA
Enumeration date
05/31/2007
Last updated
09/09/2022
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