| Doctor Name: | DR. RICH VODDE |
| NPI Number: | 1518375815 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHD SOCIAL |
| License Number: | CSW001601 |
| Business Practice Address: | 5990 Dykes Pond Rd Lake Park, GA - 316362716 |
| Business Phone Number: | 2296309335 |
| Business Fax Number: | |
| Mailing Address: | 5990 Dykes Pond Rd, LAKE PARK |
| State: | GA |
| Postal Code: | 316362716 |
| Phone Number: | 2296309335 |
| Fax Number: | |
| NPI Enumeration Date: | 07/30/2014 |
| NPI Last Update Date: | 07/30/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | CSW001601 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |