Individual
ELIZABETH ANN DODD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
4527 HARBOR DR, KINGSPORT, TN 37664-2921
(423) 360-7228
Mailing address
PO BOX 7541, KINGSPORT, TN 37664-7541
(423) 360-7228
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
074463
IA
235Z00000X
Speech-Language Pathologist
110728
TX
235Z00000X
Speech-Language Pathologist
Primary
2202000541
VA
235Z00000X
Speech-Language Pathologist
SP 0000000325
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
074463
BOARD OF SPEECH PATHOLOGY & AUDIOLOGY
IA
01
—
110728
STATE BOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY & AUDIOLOGY
TX
01
—
2202000541
BOARD OF AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY
VA
01
—
SP 0000000325
DIVISION OF HEALTH RELATED BOARDS
TN
Enumeration date
10/10/2014
Last updated
10/10/2014
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