MRS. KIMBERLY ODOM (NPI# 1073083564) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1073083564 |
Entity Type | Individual |
Full Name | MRS. KIMBERLY ODOM |
Practice Address |
2602 White Rose Dr Loganville GA 30052-2196 |
Practice Telephone | 4046442006 |
Mailing Telephone | 4046442006 |
Enumeration Date | 2018-11-28 |
Last Update Date | 2018-11-28 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2355S0801X |
Specialist/Technologist Specialization: Speech-Language Assistant |
000369 | GA | Speech, Language and Hearing Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194225722 | Kimberly L Odom | Licensed Vocational Nurse | 680 W Sam Houston Pkwy S Apt 2414, Houston, TX 77042-1570 | 2018-02-20 |
1396140331 | Kimberly Odom | Counselor | 1630 Vinson Hwy Se, Milledgeville, GA 31061-4102 | 2014-11-04 |
1558901777 | Kimberly Odom | Behavior Technician | 12015 E 46th Ave Ste 680, Denver, CO 80239-3158 | 2020-01-15 |
1386623908 | Kimberly P Odom | Pediatrics | 613 So. Myrtle Avenue, Clearwater, FL 33756 | 2006-01-12 |
Street Address |
2602 WHITE ROSE DR |
City | LOGANVILLE |
State | GA |
Zip Code | 30052-2196 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609482397 | A Better Life Together, Inc | Day Training, Developmentally Disabled Services | 3343 Woodshade Drive, Loganville, GA 30052 | 2020-09-18 |
1184285025 | Felicia Maria Anderson | Counselor | 272 Fox Run, Loganville, GA 30052 | 2019-06-21 |
1225502768 | Jackie Kabahuma Zziwa | Registered Nurse | 4072 Atlanta High Way, Loganville, GA 30052 | 2019-01-17 |
1598243024 | Afolasade A Adeyemo | In Home Supportive Care | 154 Towler Shoals Dr, Loganville, GA 30052 | 2018-08-06 |
1831688654 | Julia Smith | Physician Assistant | 2745 Loganville Hwy, Loganville, GA 30052 | 2018-05-07 |
1306335534 | Emily Jannine Jamshedi | Physician Assistant | 3461 Skyland Ridge Ct, Loganville, GA 30052 | 2018-05-03 |
1346738655 | Laura Martha Avila | Nurse Practitioner | 221 The Esplanade Way Se, Loganville, GA 30052 | 2018-04-23 |
1942738901 | Local Dental Partners, LLC | Clinic/Center | 4353 Atlanta Highway Suite. 300, Loganville, GA 30052 | 2017-06-02 |
1649702804 | Cynthia Reeves | Counselor | 4160 Logan Drive, Loganville, GA 30052 | 2017-03-28 |
1689049330 | Samuel S Kwon - Loganville Dmd PC | Dentist | 2101 Baker Carter Drive, Suite 200, Loganville, GA 30052 | 2015-12-07 |
Find all providers in zip 30052 |
Taxonomy Code | 2355S0801X |
Grouping | Speech, Language and Hearing Service Providers |
Classification | Specialist/Technologist |
Specialization | Speech-Language Assistant |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1760036156 | Candace L Hughes | Specialist/Technologist | 1058 5th Ave, Jonesboro, GA 30236-3299 | 2019-07-24 |
1043864432 | Destiny Lacara Mack | Specialist/Technologist | 160 Roberts Dr, Riverdale, GA 30274-3302 | 2019-07-24 |
1437710753 | Kristyn Spelina | Specialist/Technologist | 2775 Cruse Rd Ste 2002, Lawrenceville, GA 30044-7147 | 2019-06-26 |
1811416498 | Susan M Kirkland | Specialist/Technologist | 165 Jackson Dr, Resaca, GA 30735 | 2017-09-14 |
1558737775 | Diane Armstead | Specialist/Technologist | 809 Muirfield Trl, Marietta, GA 30068-2653 | 2015-08-12 |
1982025979 | Lm Speech | Specialist/Technologist | 2547 Ridgewood Ter Nw, Atlanta, GA 30318-1320 | 2013-12-18 |
1497090898 | Tiara Lynn | Specialist/Technologist | 3180 Blackfoot Ln, Rex, GA 30273-1065 | 2012-12-11 |
1467724351 | Bianca C Kelly | Specialist/Technologist | 3209 Saint Clair Dr Ne, Atlanta, GA 30329-2662 | 2012-02-07 |
1528349156 | Genesis Healthcare Systems LLC | Specialist/Technologist | 1885 Leland Drive, Marietta, GA 30067 | 2011-09-09 |
1306985072 | Therapist Direct Incorporated | Specialist/Technologist | 260 Bentley Place Way, Covington, GA 30016-1106 | 2007-02-06 |
Find all providers with the same taxonomy |
City | LOGANVILLE |
Zip Code | 30052 |
Please comment or provide details below to improve the information on MRS. KIMBERLY ODOM.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.