National Provider Identifier

Jennifer Dodge

Jennifer Dodge is listed in the NPPES registry with a primary specialty of Peer Specialist in Elmira, NY and a listed phone number of (607) 734-2006.

NPI 1619517422Elmira, NYPeer Specialist

Profile Overview

NPI
1619517422
Provider Type
Individual
Primary Specialty
Peer Specialist
Enumeration Date
January 09, 2020
Last Updated
January 09, 2020

Practice Location

  • 1149 Sullivan St
  • Elmira, NY 14901-1670

Phone: (607) 734-2006

Mailing Address

  • 458 Beecher St # A
  • Elmira, NY 14904-2221

Specialties

  • Peer Specialist (175T00000X)
Full Record
NPI
1619517422
Entity Type
Individual
Last Name
Dodge
First Name
Jennifer
Mailing Street Address
458 Beecher St # A
Mailing City
Elmira
Mailing State
NY
Mailing ZIP Code
14904-2221
Mailing Country
US
Mailing Phone
(607) 425-7486
Practice Street Address
1149 Sullivan St
Practice City
Elmira
Practice State
NY
Practice ZIP Code
14901-1670
Practice Country
US
Practice Phone
(607) 734-2006
Enumeration Date
January 09, 2020
Last Updated
January 09, 2020
Sex
Female
Sole Proprietor
Yes
Certification Date
January 09, 2020
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Peer Specialist (175T00000X)