Individual
MICHAEL DODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
310 MITCHEL FIELD WAY, GARDEN CITY, NY 11530-5054
(516) 428-3541
Mailing address
310 MITCHEL FIELD WAY, GARDEN CITY, NY 11530-5054
(516) 428-3541
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
05/11/2015
Last updated
05/14/2015
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