Kelly K Odum is a Clinical in Jackson, Tennessee. Kelly K Odum practices all healthcare services and medical treatments related to Clinical. The NPI Number for Kelly K Odum is 1881841476. The last update date is 2023-03-02.
Kelly K Odum's current location address is 45 Executive Dr, Jackson, Tennessee. You can contact this provider via phone number 7316642083 and fax number 7316641988. The mailing address for Kelly K Odum is 45 Executive Dr, Jackson, Tennessee. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kelly K Odum |
|---|---|
| Address | 45 Executive Dr, Jackson, Tennessee |
| Phone Number | 7316642083 |
| Fax Number | 7316641988 |
| Sole Proprietor | N |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1881841476 |
|---|---|
| Provider Enumeration Date | 2008-08-26 |
| Last Updated Date | 2023-03-02 |
Provider Mailing Address Detail
| Address | 45 Executive Dr |
|---|---|
| City | Jackson |
| State | Tennessee (TN) |
| Post Code | 383052337 |
| Phone Number | 7316642083 |
| Fax Number | 7316641988 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | LCSW3431 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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What is the unique provider identifier assigned to Kelly K Odum?
The Kelly K Odum has been issued the NPI (National Provider Identifier) 1881841476 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please provide the complete physical location address of Kelly K Odum?
The Kelly K Odum is physically situated at 45 Executive Dr, in the city of Jackson, state of TN, with the postal code 383052337.
What is the Kelly K Odum's specialty and taxonomy code?
The Kelly K Odum's specialty is Clinical, and the corresponding taxonomy code is 1041C0700X.
On what date did the Centers for Medicare & Medicaid Services issue the 1881841476 to Kelly K Odum?
The Kelly K Odum received its 1881841476 assignment from the Centers for Medicare & Medicaid Services on 2008-08-26.
When was the information related to Kelly K Odum most recently updated or refreshed?
The details pertaining to the Kelly K Odum, including its address, specialty, and other relevant information, were last updated or refreshed on 2023-03-02.
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