Individual
DR. JANICE PATRICE DODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
245 E MAIN AVE, GASTONIA, NC 28052-4142
(704) 996-8794
Mailing address
PO BOX 38365, CHARLOTTE, NC 28278-1006
(704) 996-8794
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
3560
NC
103TC0700X
Clinical Psychologist
Primary
3560
NC
103TC0700X
Clinical Psychologist
PSY 14729
CA
103TF0000X
Family Psychologist
3560
NC
103TF0200X
Forensic Psychologist
3560
NC
103TM1800X
Intellectual & Developmental Disabilities Psychologist
3560
NC
103TP0814X
Psychoanalysis Psychologist
3560
NC
103TP2701X
Group Psychotherapy Psychologist
3560
NC
Other
Enumeration date
06/10/2013
Last updated
06/09/2015
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