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Individual

MS. JACQUELINE REBEL DODGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ED.D.

Contact information

Practice address
1441 SACHEM PL, SUITE 4, CHARLOTTESVILLE, VA 22901-2555
(434) 971-1701
(434) 963-9206
Mailing address
1441 SACHEM PL, SUITE 4, CHARLOTTESVILLE, VA 22901-2555
(434) 971-1701
(434) 963-9206

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701000837
VA

Other

Enumeration date
12/15/2006
Last updated
07/08/2007
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