Provider Demographics
NPI:1851385256
Name:ODELL, BELINDA A (SLP)
Entity Type:Individual
Prefix:MS
First Name:BELINDA
Middle Name:A
Last Name:ODELL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 FOX DEN CT
Mailing Address - Street 2:
Mailing Address - City:TALKING ROCK
Mailing Address - State:GA
Mailing Address - Zip Code:30175-7238
Mailing Address - Country:US
Mailing Address - Phone:912-223-0967
Mailing Address - Fax:706-698-1007
Practice Address - Street 1:25 FOX DEN CT
Practice Address - Street 2:
Practice Address - City:TALKING ROCK
Practice Address - State:GA
Practice Address - Zip Code:30175-7238
Practice Address - Country:US
Practice Address - Phone:912-223-0967
Practice Address - Fax:706-698-1007
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA9735235Z00000X
GASLP005622235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA155808701AMedicaid
FL001029800Medicaid
FL001989100Medicaid
GA155808701DMedicaid
GA155808701CMedicaid