Individual
ANNA W DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
1595 SOQUEL DR, 230, SANTA CRUZ, CA 95065-1719
(831) 476-4414
Mailing address
1595 SOQUEL DRIVE, 230, SOQUEL, CA 95065
(831) 476-4414
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AU2791
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AU2791
SPEECH LANGUAGE PATHOLOGY AND AUDIOLOGY BOARD
CA
Enumeration date
08/11/2011
Last updated
08/11/2011
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