Provider Demographics
NPI:1326276502
Name:DODSON, HEATHER ANN (MSW)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:ANN
Last Name:DODSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2265 N 13TH ST
Mailing Address - Street 2:
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82072-1810
Mailing Address - Country:US
Mailing Address - Phone:307-760-8595
Mailing Address - Fax:307-745-8453
Practice Address - Street 1:2265 N 13TH ST
Practice Address - Street 2:
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82072-1810
Practice Address - Country:US
Practice Address - Phone:307-760-8595
Practice Address - Fax:307-745-8453
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-26
Last Update Date:2009-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator