Individual
MRS. DIANE DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8801 N 56TH ST, CHEROKEE ELEMENTARY SCHOOL, PARADISE VALLEY, AZ 85253-2246
(480) 484-8700
Mailing address
3923 E SHANGRI LA RD, PHOENIX, AZ 85028-2820
(602) 622-0374
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP0009
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
629131
ARIZONA HEALTH CARE COST
AZ
Enumeration date
01/26/2007
Last updated
07/08/2007
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