Individual
MISS JESSICA LYNELLE DODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BA
Contact information
Practice address
1501 W. COMMERCE, YUKON, OK 73099
(405) 354-1927
(405) 354-3927
Mailing address
2609 FEATHERSTONE RD, APT 540, OKLAHOMA CITY, OK 73120-2105
(405) 819-8500
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/29/2006
Last updated
07/08/2007
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