Provider Demographics
NPI:1245795681
Name:DODGSON, DEVYN CAMILLE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DEVYN
Middle Name:CAMILLE
Last Name:DODGSON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1281 S WARD CT
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-3839
Mailing Address - Country:US
Mailing Address - Phone:505-670-5361
Mailing Address - Fax:
Practice Address - Street 1:2525 S WADSWORTH BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-3273
Practice Address - Country:US
Practice Address - Phone:720-962-4555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-08
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28241235Z00000X
COSLP.0005267235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty