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General NPI Number Information
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NPI Number | 1508366774
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Entity Type | Individual
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Provider Name | ALYSON DODELL MFT, BCBA
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Gender | Female
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Dates
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Enumeration Date | 02/14/2018
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Last Update Date | 12/28/2023
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Provider Practice Location Address
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Address Line | 19725 SHERMAN WAY STE 380
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City | WINNETKA
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State | CA
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Zip | 91306-3661
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Country | US
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Telephone | 310-247-8712
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Fax |
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Provider Business Mailing Address
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Address Line | 28958 MEDEA MESA RD
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City | AGOURA
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State | CA
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Zip | 91301-2745
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Country | US
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Telephone | 818-398-9132
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 99267
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 12151098
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License Number State | CA
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