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NPI Code Detail

MEDICARE: MRS. MARTHA DODSON LCSW

MEDICARE: MRS. MARTHA DODSON LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker1408GA

General Provider Information

NPI Number : 1902953375
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARTHA DODSON LCSW
Provider Business Mailing Address
First Line : 2022 15TH AVE
Second Line :
City : COLUMBUS
State : GA
Zip : 31901-1608
Country : US
Telephone Number : 706-649-6500
Fax Number : 706-649-6521
Provider Business Practice Location Address
First Line : 2022 15TH AVE
Second Line :
City : COLUMBUS
State : GA
Zip : 31901-1608
Country : US
Telephone Number : 706-649-6500
Fax Number : 706-649-6521
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2007
Last Update Date : 12/20/2007

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