Provider Demographics
NPI:1437126729
Name:DODD, ANNETTE K (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:K
Last Name:DODD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:ANN
Other - Middle Name:
Other - Last Name:DODD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:PSC 80 BOX 14063
Mailing Address - Street 2:APO
Mailing Address - City:AP
Mailing Address - State:OKINAWA
Mailing Address - Zip Code:96367
Mailing Address - Country:JP
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PSC 80 BOX 14063
Practice Address - Street 2:APO
Practice Address - City:AP
Practice Address - State:OKINAWA
Practice Address - Zip Code:96367
Practice Address - Country:JP
Practice Address - Phone:01181611-734-0871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-05
Last Update Date:2009-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 223111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical