Dodge, Gordon R

Dodge, Gordon R is an individual health care provider with primary practice located at 204 Summit Ave , Center City MN 55012. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Dodge, Gordon R can be contacted via phone (651) 303-2355.

Contact Information

Primary practice address
204 Summit Ave Center City MN 55012
Phone: (651) 303-2355
Fax: (651) 464-5744
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X LP1221 Minnesota

Profile Details

NPI number 1902026131
LBN Legal business name Dodge, Gordon R
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 30th, 2007
Last updated Jul 8th, 2007 - about 17 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.

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