MRS. KIMBERLY ODOM
NPI 1073083564
Specialist/Technologist - Speech-Language Assistant in Loganville, GA
Active since November 28, 2018
About Mrs. Kimberly Odom NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MRS. KIMBERLY ODOM (NPI 1073083564) is an individual speech-language assistant in Loganville, Georgia, licensed in Georgia (000369) and active in the NPI registry since November 2018.
NPPES Registry Identity
NPI1073083564
Entity TypeIndividualFemale
Primary Taxonomy2355S0801X
Provider Legal NameMRS. KIMBERLY ODOM
Location Address2602 WHITE ROSE DRLoganville, GA 30052-2196
Mailing Address2602 White Rose DrLoganville, GA 30052-2196 · (404) 644-2006
Phone(404) 644-2006
Sole ProprietorNo
Enumeration DateNovember 28, 2018
Last NPPES UpdateJuly 10, 20252 updates tracked since enumeration
NPPES CertifiedJuly 7, 2025
✔ NPI 1073083564 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtySpecialist/Technologist · Speech-Language AssistantSpeech, Language and Hearing Service Providers
Taxonomy Code2355S0801X
License✔ Licensed in GA · 000369
2602 WHITE ROSE DR, Loganville, GA 30052
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1073083564, enumerated as an "individual" on November 28, 2018.
The provider is located at 2602 WHITE ROSE DR LOGANVILLE, GA 30052 and the phone number is (404) 644-2006.
Specialist/Technologist with taxonomy code 2355S0801X and a focus in Speech-Language Assistant.
