Provider Demographics
NPI:1821658204
Name:DODSON, DELANEY ELIZABETH RYDER
Entity Type:Individual
Prefix:
First Name:DELANEY
Middle Name:ELIZABETH RYDER
Last Name:DODSON
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 1:401 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2881
Mailing Address - Country:US
Mailing Address - Phone:217-341-1547
Mailing Address - Fax:
Practice Address - Street 1:401 MARKET ST
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2881
Practice Address - Country:US
Practice Address - Phone:740-314-5339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-18
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1901698-TRNE101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health