Dodge, Angeleen
Dodge, Angeleen is an individual health care provider with primary practice located at 500 N Park Ave , Fond Du Lac WI 54935-1943. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Dodge, Angeleen can be contacted via phone (920) 929-8858.Contact Information
Primary practice address
500 N Park Ave
Fond Du Lac WI 54935-1943
Phone: (920) 929-8858
Fax: (920) 923-3038
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 1962-154 | Wisconsin |
Profile Details
| NPI number | 1104041748 |
|---|---|
| LBN Legal business name | Dodge, Angeleen |
| Credentials | SLP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 17th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104041748 | NPPES |
| Wisconsin | MEDICAID | 42773400 |
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