Dodge, Timothy Dean

Dodge, Timothy Dean is an individual health care provider with primary practice located at 18975 W 115Th Ter , Olathe KS 66061-6542. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Dodge, Timothy Dean can be contacted via phone (913) 232-6861.

Contact Information

Primary practice address
18975 W 115Th Ter Olathe KS 66061-6542
Phone: (913) 232-6861
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 2002011102 Missouri
Behavioral Health & Social Service Providers / Psychologist 103T00000X 1256 Kansas

Profile Details

NPI number 1598926362
LBN Legal business name Dodge, Timothy Dean
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 24th, 2008
Last updated Sep 5th, 2012 - about 14 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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Identifiers

StateTypeNumberIssuer
All States NPI 1598926362 NPPES
Missouri MEDICAID 493776314

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