Individual
DIANE MARIE DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
800 HOWARD AVE, YALE PHYSICIANS BLDG, NEW HAVEN, CT 06519-1369
(203) 785-2140
(203) 785-6414
Mailing address
291 WHITNEY AVE, NEW HAVEN, CT 06511-3724
(203) 710-4492
(203) 737-5455
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
003485
CT
Other
Enumeration date
12/01/2006
Last updated
02/05/2024
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