Individual
BENJAMIN DODSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
32300 S 625 RD, GROVE, OK 74344-6285
(918) 786-2930
(918) 786-5985
Mailing address
PO BOX 451585, GROVE, OK 74345-1585
(918) 786-2930
(918) 786-5985
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2001129910
—
OK
Enumeration date
05/28/2015
Last updated
06/15/2015
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