Provider Demographics
NPI:1144417205
Name:DODD, GAIL A (LADC)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:A
Last Name:DODD
Suffix:
Gender:F
Credentials:LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 SWEDEN STREET
Mailing Address - Street 2:
Mailing Address - City:CARIBOU
Mailing Address - State:ME
Mailing Address - Zip Code:04736
Mailing Address - Country:US
Mailing Address - Phone:207-325-4727
Mailing Address - Fax:207-325-4727
Practice Address - Street 1:24 SWEDEN ST
Practice Address - Street 2:
Practice Address - City:CARIBOU
Practice Address - State:ME
Practice Address - Zip Code:04736-2127
Practice Address - Country:US
Practice Address - Phone:207-325-4727
Practice Address - Fax:207-325-4727
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME4011101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)