Individual
MARY DODGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2722 HIGHWAY 25 S, GREENWOOD, SC 29646-9083
(864) 344-6987
Mailing address
2722 HIGHWAY 25 S, GREENWOOD, SC 29646-9083
(864) 344-6987
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5366
SC
Other
Enumeration date
01/16/2023
Last updated
01/16/2023
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