Individual
CYNTHIA A DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
25827 N 122ND LN, PEORIA, AZ 85383-5814
(928) 863-8431
Mailing address
30 COLINAS, SEDONA, AZ 86351-9238
(928) 853-8269
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
LC4083
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
194420299
—
ME
01
—
RB9
ANTHEM
ME
Enumeration date
11/15/2006
Last updated
10/26/2021
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