IndividualActive
Kimberly Odom
NPI 1073083564 · Speech-Language Assistant · Loganville, GA
Provider details
- NPI number
- 1073083564
- Entity type
- Individual
- Primary specialty
- Speech-Language AssistantSpeech, Language and Hearing Service Providers
- Sex
- Female
- Sole proprietor
- No
- License
- 000369 (GA)
Specialties & taxonomies
Speech, Language and Hearing Service Providers
Practice location
2602 White Rose Dr
Loganville, GA 30052-2196
Phone: (404) 644-2006
Approximate (ZIP-level) locationGet directions
Mailing address
2602 White Rose Dr
Loganville, GA 30052-2196
Registry dates
- Enumerated
- 2018-11-28
- Last updated
- 2025-07-10
- Certified
- 2025-07-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.