Individual
DIANNE DODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1428 HUDSON LNDG, SAINT CHARLES, MO 63303-6174
(314) 302-7999
Mailing address
1428 HUDSON LNDG, SAINT CHARLES, MO 63303-6174
(314) 302-7999
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW005277
MO
Other
Enumeration date
02/18/2010
Last updated
02/18/2010
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