Provider Demographics
NPI:1376681049
Name:DODD, SANDRA ULRIKE
Entity Type:Individual
Prefix:MISS
First Name:SANDRA
Middle Name:ULRIKE
Last Name:DODD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9111 CROSS PARK DR
Mailing Address - Street 2:SUITE E-475
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4506
Mailing Address - Country:US
Mailing Address - Phone:865-560-2569
Mailing Address - Fax:
Practice Address - Street 1:9111 CROSS PARK DR
Practice Address - Street 2:SUITE E-475
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4506
Practice Address - Country:US
Practice Address - Phone:865-560-2569
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor