Provider Demographics
NPI:1104666312
Name:DOVER, RODNESHA
Entity type:Individual
Prefix:
First Name:RODNESHA
Middle Name:
Last Name:DOVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2112 S CYPRESS BEND DR APT 908
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33069-4454
Mailing Address - Country:US
Mailing Address - Phone:954-588-1356
Mailing Address - Fax:
Practice Address - Street 1:11055 SW 186TH ST STE 306
Practice Address - Street 2:
Practice Address - City:CUTLER BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-6843
Practice Address - Country:US
Practice Address - Phone:786-224-6884
Practice Address - Fax:786-688-2483
Is Sole Proprietor?:No
Enumeration Date:2024-05-28
Last Update Date:2024-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical