Individual
MRS. JILL KATHLEEN DODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3990 OLD TOWN AVE, STE 209A, SAN DIEGO, CA 92110-2967
(619) 615-5065
(619) 294-9181
Mailing address
3990 OLD TOWN AVE, STE 209A, SAN DIEGO, CA 92110
(619) 615-5065
(619) 294-9181
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
LCS5760
CA
Other
Enumeration date
02/23/2007
Last updated
01/26/2018
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