Provider Demographics
NPI:1871768705
Name:ODOM, CLAYLEENE ELIZABETH (AUD)
Entity type:Individual
Prefix:
First Name:CLAYLEENE
Middle Name:ELIZABETH
Last Name:ODOM
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9301 PINECROFT DR
Mailing Address - Street 2:#100
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3179
Mailing Address - Country:US
Mailing Address - Phone:281-364-1001
Mailing Address - Fax:281-364-9095
Practice Address - Street 1:9301 PINECROFT DR
Practice Address - Street 2:#100
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3179
Practice Address - Country:US
Practice Address - Phone:281-364-1001
Practice Address - Fax:281-364-9095
Is Sole Proprietor?:No
Enumeration Date:2008-04-22
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51159231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist