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Individual

DEBRA LEE DODGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
88 SUMMER ST, MEDWAY, MA 02053-2383
(508) 533-6643
Mailing address
406 PAKACHOAG ST, AUBURN, MA 01501-2425
(508) 517-1058

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
114561
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
22
MA
Enumeration date
09/21/2018
Last updated
09/21/2018
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