Individual
CAROL LUCKE DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
265 S HARLAN ST, LAKEWOOD, CO 80226-2261
(720) 272-1289
Mailing address
265 S HARLAN ST, LAKEWOOD, CO 80226-2261
(720) 272-1289
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
04/19/2019
Last updated
04/19/2019
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