Provider Demographics
NPI:1770272882
Name:DODD, KAYLEE
Entity type:Individual
Prefix:
First Name:KAYLEE
Middle Name:
Last Name:DODD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAYLEE
Other - Middle Name:
Other - Last Name:BASS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1413 TECH BLVD STE 122
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33619-7822
Mailing Address - Country:US
Mailing Address - Phone:813-305-2867
Mailing Address - Fax:
Practice Address - Street 1:1413 TECH BLVD
Practice Address - Street 2:SUITE 122
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33619-7822
Practice Address - Country:US
Practice Address - Phone:813-305-2867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician