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Individual

STEPHANIE ANN DODGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
688 KINOOLE ST, HILO, HI 96720-3877
(808) 747-3445
(808) 443-5196
Mailing address
PO BOX 11339, HILO, HI 96721
(808) 747-3445

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY1318
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000000000
I DON'T HAVE ANOTHER IDENTIFICATION NUMBER
Enumeration date
05/15/2012
Last updated
09/26/2024
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