Provider Demographics
NPI:1194888123
Name:DODSON, BRUCE AARON (LPC)
Entity type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:AARON
Last Name:DODSON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:105 RUBY ST
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-7237
Mailing Address - Country:US
Mailing Address - Phone:501-625-7359
Mailing Address - Fax:501-623-2629
Practice Address - Street 1:1401 MALVERN AVE
Practice Address - Street 2:SUITE 280
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-6327
Practice Address - Country:US
Practice Address - Phone:501-318-1337
Practice Address - Fax:501-623-2629
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP0405017101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional