Provider Demographics
NPI:1245080365
Name:DODSON, CLAIRE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:
Last Name:DODSON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8301 RIDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61201-7605
Mailing Address - Country:US
Mailing Address - Phone:309-948-1783
Mailing Address - Fax:
Practice Address - Street 1:2351 31ST ST
Practice Address - Street 2:
Practice Address - City:MOLINE
Practice Address - State:IL
Practice Address - Zip Code:61265-4306
Practice Address - Country:US
Practice Address - Phone:309-948-1783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146017557235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist