Individual
MS. LISA DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LLP, CAADC
Contact information
Practice address
23965 NOVI RD STE 130, NOVI, MI 48375-0204
(248) 946-4664
Mailing address
1068 TRAILSIDE BLVD, WIXOM, MI 48393-1587
(248) 926-0871
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6361007904
MI
Other
Enumeration date
09/13/2010
Last updated
05/23/2024
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