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Individual

MRS. TYECE LANA DODGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
10015 NE 127TH CT, VANCOUVER, WA 98682-1809
(360) 260-7304
Mailing address
10015 NE 127TH CT, VANCOUVER, WA 98682-1809
(360) 260-7304

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary

Other

Enumeration date
01/17/2013
Last updated
01/17/2013
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