Healthcare Provider Details

I. General information

NPI: 1871254979
Provider Name (Legal Business Name): LAKEISHA RENEE THOMAS DODD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/01/2022
Last Update Date: 05/10/2026
Certification Date: 05/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 1ST AVE APT 2
MIDDLETOWN OH
45044-4185
US

IV. Provider business mailing address

1500 1ST AVE APT 2
MIDDLETOWN OH
45044-4185
US

V. Phone/Fax

Practice location:
  • Phone: 513-464-3345
  • Fax:
Mailing address:
  • Phone: 513-464-3345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberPRS.007802
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number0907006
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: