DESIREE EVETTE ODOM NPI 1619823960

NPI Information

  • NPI: 1619823960
  • Provider Name: DESIREE EVETTE ODOM
  • Classification: Massage Therapist - 225700000X
  • Entity Type: Individual
  • Address: 309 MAPLE ST
    SYRACUSE, NY
    ZIP 13210
  • Phone: (315) 475-9164

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NPI Details

Desiree Evette Odom is a massage therapist in Syracuse, NY. The provider is an individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. Desiree Evette Odom NPI is 1619823960. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

309 MAPLE ST
SYRACUSE, NY
ZIP 13210-248
Phone: (315) 475-9164

The enumeration date for this NPI number is 3/9/2026 and was last updated on 3/9/2026.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1225700000XMassage Therapist033204-01NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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