| Doctor Name: | MS. MARY M. ODOM |
| NPI Number: | 1285049791 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 6940C |
| Business Practice Address: | 708 Highway 65 S Dumas, AR - 716393004 |
| Business Phone Number: | 8703824001 |
| Business Fax Number: | 8703826094 |
| Mailing Address: | 790 Roberts Drive, MONTICELLO |
| State: | AR |
| Postal Code: | 71655 |
| Phone Number: | 8703672461 |
| Fax Number: | 8704606133 |
| NPI Enumeration Date: | 06/23/2014 |
| NPI Last Update Date: | 09/01/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 6940C |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |