Provider Demographics
NPI:1063636066
Name:IUNI-DODGE, ANNMARIE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANNMARIE
Middle Name:
Last Name:IUNI-DODGE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:617 UNION AVE
Mailing Address - Street 2:BUILDING 2, SUITE 13
Mailing Address - City:BRIELLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08730-1838
Mailing Address - Country:US
Mailing Address - Phone:732-974-2827
Mailing Address - Fax:732-886-2671
Practice Address - Street 1:617 UNION AVE
Practice Address - Street 2:BUILDING 2, SUITE 13
Practice Address - City:BRIELLE
Practice Address - State:NJ
Practice Address - Zip Code:08730-1838
Practice Address - Country:US
Practice Address - Phone:732-974-2827
Practice Address - Fax:732-886-2671
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical