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Contact Information

GORDON R DODGE, PHD
204 SUMMIT AVE
CENTER CITY, MN55012
 Phone: 651-303-2355
 Fax: 651-464-5744
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychologist

103T00000X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for GORDON R DODGE · (Male)

NPI Number 1902026131
Status Active
Credentials PHD
Entity Individual
Enumeration date 04/30/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • MN License # LP1221
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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