Provider Demographics
NPI:1225638208
Name:DODSON, QUIANA (RMA)
Entity Type:Individual
Prefix:
First Name:QUIANA
Middle Name:
Last Name:DODSON
Suffix:
Gender:F
Credentials:RMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:268 PARKGATE AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-3240
Mailing Address - Country:US
Mailing Address - Phone:330-398-0355
Mailing Address - Fax:
Practice Address - Street 1:552 N PARK AVE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44481-1117
Practice Address - Country:US
Practice Address - Phone:234-243-3127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist