Dodge, Kevin

Dodge, Kevin is an individual health care provider with primary practice located at 1003 Martin Luther King Dr , Bloomington IL 61701-1429. He recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as his primary health care specialty. Dodge, Kevin can be contacted via phone (309) 827-6026.

Contact Information

Primary practice address
1003 Martin Luther King Dr Bloomington IL 61701-1429
Phone: (309) 827-6026
Fax: (309) 820-3745
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X

Profile Details

NPI number 1114355351
LBN Legal business name Dodge, Kevin
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 25th, 2013
Last updated Oct 25th, 2013 - about 11 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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