Provider Demographics
NPI:1629663505
Name:DODS, ANGELA WILSON
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:WILSON
Last Name:DODS
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 1:1002 SEQUOYAH DR
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-6925
Mailing Address - Country:US
Mailing Address - Phone:580-366-7450
Mailing Address - Fax:
Practice Address - Street 1:1002 SEQUOYAH DR
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-6925
Practice Address - Country:US
Practice Address - Phone:580-366-7450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-03
Last Update Date:2021-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist