Provider Demographics
NPI:1487187472
Name:DODGSON, ALEXA K
Entity Type:Individual
Prefix:
First Name:ALEXA
Middle Name:K
Last Name:DODGSON
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:PO BOX 603
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE ON DE
Mailing Address - State:PA
Mailing Address - Zip Code:18356-0603
Mailing Address - Country:US
Mailing Address - Phone:973-668-2886
Mailing Address - Fax:
Practice Address - Street 1:8865 NORWIN AVE
Practice Address - Street 2:SUITE 27, #123
Practice Address - City:NORTH HUNTINGDON
Practice Address - State:PA
Practice Address - Zip Code:15642-2769
Practice Address - Country:US
Practice Address - Phone:866-287-2036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-06
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician