Individual
JODI KAITLYN DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2112 W MAIN ST, CLARKSVILLE, AR 72830-3245
(479) 647-3022
(479) 567-5471
Mailing address
3205 W MAIN ST, RUSSELLVILLE, AR 72801-2301
(479) 567-5470
(479) 567-5471
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
AR
Other
Enumeration date
05/01/2023
Last updated
05/01/2023
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