Provider Demographics
NPI:1184294613
Name:DODSON, KATHRYN (CDCA)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:DODSON
Suffix:
Gender:F
Credentials:CDCA
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:
Other - Last Name:DODSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CDCA
Mailing Address - Street 1:1970 ABERDEEN DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-2982
Mailing Address - Country:US
Mailing Address - Phone:614-537-1631
Mailing Address - Fax:
Practice Address - Street 1:3433 AGLER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-3387
Practice Address - Country:US
Practice Address - Phone:614-599-6869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)