Provider Demographics
NPI:1194268094
Name:DODDATO, ALEXIS
Entity type:Individual
Prefix:MS
First Name:ALEXIS
Middle Name:
Last Name:DODDATO
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 1:452 N EOLA RD
Mailing Address - Street 2:SUITE A BEHAVIORAL PERSPECTIVES INC
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60502-9612
Mailing Address - Country:US
Mailing Address - Phone:612-227-7203
Mailing Address - Fax:
Practice Address - Street 1:452 N EOLA RD
Practice Address - Street 2:SUITE A BEHAVIORAL PERSPECTIVES INC
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60502-9612
Practice Address - Country:US
Practice Address - Phone:612-227-7203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-23
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician