Provider Demographics
NPI:1750423356
Name:BODI, DAWN MARIE (LPC)
Entity type:Individual
Prefix:MS
First Name:DAWN
Middle Name:MARIE
Last Name:BODI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:DAWN
Other - Middle Name:MARIE
Other - Last Name:KINNEY PEABODY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 362
Mailing Address - Street 2:
Mailing Address - City:SAND SPRINGS
Mailing Address - State:OK
Mailing Address - Zip Code:74063-0362
Mailing Address - Country:US
Mailing Address - Phone:918-810-2588
Mailing Address - Fax:
Practice Address - Street 1:616 S BOSTON AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74119-1208
Practice Address - Country:US
Practice Address - Phone:918-382-7300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health