| Doctor Name: | MRS. JACQUELINE ODUSELU |
| NPI Number: | 1922467414 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MS, NCC, LPC |
| License Number: | LPC008829 |
| Business Practice Address: | 1905 Woodstock Rd Suite 7150 Roswell, GA - 300755616 |
| Business Phone Number: | 4046445523 |
| Business Fax Number: | |
| Mailing Address: | Po Box 2656, ACWORTH |
| State: | GA |
| Postal Code: | 301020012 |
| Phone Number: | 4046445523 |
| Fax Number: | |
| NPI Enumeration Date: | 02/12/2016 |
| NPI Last Update Date: | 02/28/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | LPC008829 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |