Provider Demographics
NPI:1447689120
Name:DODD, DAVID (PHD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:DODD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 GRASSMERE PARK
Mailing Address - Street 2:SUITE 11
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-3662
Mailing Address - Country:US
Mailing Address - Phone:615-837-2282
Mailing Address - Fax:615-837-0728
Practice Address - Street 1:624 GRASSMERE PARK
Practice Address - Street 2:SUITE 11
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-3662
Practice Address - Country:US
Practice Address - Phone:615-837-2282
Practice Address - Fax:615-837-0728
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-04
Last Update Date:2013-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000000567101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health