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Individual
THOMAS M DODGE
Active
Individual
THOMAS M DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
RN2351706
MA
2255A2300X
Athletic Trainer
1797
MA
364SP0810X
Child & Family Psychiatric/Mental Health Clinical Nurse Specialist
Primary
RN2351706
MA
Other
Enumeration date
11/28/2012
Last updated
10/26/2023
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