Individual
ANGELEEN DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
500 N PARK AVE, FOND DU LAC, WI 54935-1943
(920) 929-8858
(920) 923-3038
Mailing address
500 N PARK AVE, FOND DU LAC, WI 54935-1943
(920) 929-8858
(920) 923-3038
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1962-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42773400
—
WI
Enumeration date
04/17/2007
Last updated
07/08/2007
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