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Individual

DR. MICHELE FRANCES DODDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD, LP

Contact information

Practice address
4027 COUNTY ROAD 25, MINNEAPOLIS, MN 55416-2629
(612) 925-6033
(612) 925-8496
Mailing address
4240 PARK GLEN RD, ST LOUIS PARK, MN 55416-5427
(612) 925-6033
(612) 925-8496

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
LP3142
MN
103TC0700X
Clinical Psychologist
Primary
LP3142
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1011623
PREFERRED ONE
MN
01
532019400
MEDICAL ASSISTANCE
01
8H361D0
BLUE CROSS BLUE SHIELD
MN
Enumeration date
07/26/2007
Last updated
10/26/2023
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