MRS. KIMBERLY ODOM


Address: 2602 White Rose Dr, Loganville, GA 30052-2196
Phone: 4046442006

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).

Provider Overview

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

Taxonomy

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

Other Providers KIMBERLY ODOM

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

Office Location

Street Address 2602 WHITE ROSE DR
City LOGANVILLE
State GA
Zip Code 30052-2196

Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 2355S0801X
Grouping Speech, Language and Hearing Service Providers
Classification Specialist/Technologist
Specialization Speech-Language Assistant

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

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
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Competitor

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City LOGANVILLE
Zip Code 30052

Improve Information

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Dataset Information

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.

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