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General NPI Number Information
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NPI Number | 1720375686
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Entity Type | Organization
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Legal Business Name | STEPHANIE DODOO COUNSELING & CONSULTING LLC
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Dates
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Enumeration Date | 06/29/2011
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Last Update Date | 06/29/2011
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Provider Practice Location Address
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Address Line | 3810 MEDICAL PKWY SUITE 232
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City | AUSTIN
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State | TX
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Zip | 78756-4026
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Country | US
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Telephone | 512-374-1803
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 142275
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City | AUSTIN
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State | TX
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Zip | 78714-2275
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Country | US
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Telephone | 512-374-1803
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Fax |
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Authorized Official
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Title or Position | THERAPIST/SOCIAL WORKER
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Name | STEPHANIE DODOO
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Credential | M.A. LCSW
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Telephone | 512-374-1803
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 53048
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License Number State | TX
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