FRED DAVID DODGE

MERIDIAN, ID
NPI1669117438
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: ID  LCSW-40095)
Enumeration Date2022-05-04
Last Update Date2022-05-04
Business Address
FRED DAVID DODGE LCSW
2650 S EAGLE RD
MERIDIAN, ID 83642-6725
Phone number: 986-200-4290
Mailing Address
FRED DAVID DODGE LCSW
2725 VIA VALDARNO
POCATELLO, ID 83201-5830
Phone number: 512-630-5140
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