Individual
SANDRA LEE DODSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED,LCADC,LPCA,QMRP
Contact information
Practice address
1203 AMERICAN GREETING CARD RD, CORBIN, KY 40701-4811
(606) 528-7010
Mailing address
PO BOX 568, CORBIN, KY 40702-0568
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
165078
KY
101YM0800X
Mental Health Counselor
128628
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100417220
—
KY
Enumeration date
02/08/2010
Last updated
09/27/2016
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