Provider Demographics
NPI:1043774078
Name:YOUR PRIORITY, LLC.
Entity Type:Organization
Organization Name:YOUR PRIORITY, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LESLI
Authorized Official - Middle Name:
Authorized Official - Last Name:ODUM
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:407-801-9628
Mailing Address - Street 1:6396 ROYAL TERN ST
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-6012
Mailing Address - Country:US
Mailing Address - Phone:407-801-9628
Mailing Address - Fax:
Practice Address - Street 1:6396 ROYAL TERN ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-6012
Practice Address - Country:US
Practice Address - Phone:407-801-9628
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty