Organization
DIXIE H DODGE PHD PC
Active
Other names
Dixie H Dodge PhD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIXIE H DODGE PHD PSYCHOLOGY (PRESIDENT)
(719) 636-2669
Entity
Organization
Contact information
Practice address
219 EAST ST VRAIN, COLORADO SPRINGS, CO 80903
(719) 636-2669
(719) 577-9656
Mailing address
219 EAST ST VRAIN, COLORADO SPRINGS, CO 80903
(719) 636-2669
(719) 577-9656
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1171
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
034211
MEDICADE
CO
01
—
10412365
CAQH
—
01
—
35197
ANTHEM
—
01
—
80206
BLUE CROSS
—
Enumeration date
02/27/2007
Last updated
11/26/2007
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