Provider Demographics
NPI:1538035894
Name:DODD, MADELINE GRACE
Entity type:Individual
Prefix:
First Name:MADELINE
Middle Name:GRACE
Last Name:DODD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MADDIE
Other - Middle Name:
Other - Last Name:DODD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1200 THURSTON ST
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-5246
Mailing Address - Country:US
Mailing Address - Phone:970-420-2915
Mailing Address - Fax:
Practice Address - Street 1:1200 THURSTON ST
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-5246
Practice Address - Country:US
Practice Address - Phone:816-469-5162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-14
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician