Individual
MRS. BONNY LU DODSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
40 SUMMER ST, BANGOR, ME 04401-6446
(207) 947-0366
(207) 990-3896
Mailing address
100 ABBOTT LN, ETNA, ME 04434-3041
(207) 269-2703
(207) 990-3896
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC4142
ME
Other
Enumeration date
05/15/2007
Last updated
07/09/2007
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