Individual
DR. JESSICA K DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LP, BCBA
Contact information
Practice address
3333 UNIVERSITY AVE SE, MINNEAPOLIS, MN 55414-3325
(952) 767-6964
Mailing address
3333 UNIVERSITY AVE SE, MINNEAPOLIS, MN 55414-3325
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP6028
MN
Other
Enumeration date
09/02/2016
Last updated
09/02/2016
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