NPI Profile for MARISSA DODGE in POLAND, ME.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Addiction (Substance Use Disorder) |
101YA0400X |
| NPI # | 1396502720 |
|
| Status | Active | |
| Credentials | LADC, CCS | |
| Entity | Individual | |
| Enumeration date | 03/04/2024 | |
| Last updated | 03/04/2024 - About 2 years ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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MARISSA DODGE
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