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General NPI Number Information
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NPI Number | 1760771646
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Entity Type | Individual
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Provider Name | AUBRY DAWN DODGE M.S., B.C.B.A.
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Gender | Female
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Dates
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Enumeration Date | 03/31/2011
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Last Update Date | 03/31/2011
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Provider Practice Location Address
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Address Line | 3300 DEXTER RD
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City | ANN ARBOR
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State | MI
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Zip | 48103-2768
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Country | US
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Telephone | 734-277-7072
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Fax | 734-929-4937
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Provider Business Mailing Address
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Address Line | 3300 DEXTER RD
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City | ANN ARBOR
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State | MI
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Zip | 48103-2768
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Country | US
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Telephone |
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 1-10-7887
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License Number State | MI
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