Doctor Name: | MS. KAY L DODRILL |
NPI Number: | 1043341456 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LMHC |
License Number: | MH3401 |
Business Practice Address: | 3750 Sw 47th Ave West Park, FL - 330235557 |
Business Phone Number: | 9543030308 |
Business Fax Number: | |
Mailing Address: | 3750 Sw 47th Ave, WEST PARK |
State: | FL |
Postal Code: | 330235557 |
Phone Number: | 9543030308 |
Fax Number: | |
NPI Enumeration Date: | 03/08/2007 |
NPI Last Update Date: | 05/18/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MH3401 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |