Individual
TYLEIGH DODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1304 NASHVILLE RD, HORSESHOE BEND, AR 72512-3110
(870) 750-0694
Mailing address
1304 NASHVILLE RD, HORSESHOE BEND, AR 72512-3110
(870) 750-0694
Taxonomy
Speciality
Code
Description
License number
State
373H00000X
Day Training/Habilitation Specialist
Primary
—
—
Other
Enumeration date
03/14/2012
Last updated
03/14/2012
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