| Doctor Name: | THOMAS ODELL DUVALL |
| NPI Number: | 1437145331 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMHC, LPC, NCC |
| License Number: | LPC005142 |
| Business Practice Address: | 1593 Hwy 393 Santa Rosa Beach, FL - 324598813 |
| Business Phone Number: | 8503686535 |
| Business Fax Number: | |
| Mailing Address: | Po Box 444, NICEVILLE |
| State: | FL |
| Postal Code: | 325880444 |
| Phone Number: | 8503686535 |
| Fax Number: | |
| NPI Enumeration Date: | 09/26/2005 |
| NPI Last Update Date: | 09/01/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | LPC005142 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |