Individual
DR. THERESA DODDATO
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RN, PH.D
Contact information
Practice address
1207 N WEST ST, JACKSON, MS 39202-2018
(601) 354-6654
(601) 354-6289
Mailing address
130 WATERWOOD DR, BRANDON, MS 39047-6527
(601) 919-1631
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
R856512
NY
Other
Enumeration date
03/22/2006
Last updated
07/08/2007
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