Provider Demographics
NPI:1588903413
Name:DODD, ZANE BARRETT (PHD)
Entity type:Individual
Prefix:DR
First Name:ZANE
Middle Name:BARRETT
Last Name:DODD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:621 N MAIN ST
Mailing Address - Street 2:#440
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-9213
Mailing Address - Country:US
Mailing Address - Phone:817-416-8970
Mailing Address - Fax:856-677-9448
Practice Address - Street 1:621 N MAIN ST
Practice Address - Street 2:#440
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-9213
Practice Address - Country:US
Practice Address - Phone:817-416-8970
Practice Address - Fax:856-677-9448
Is Sole Proprietor?:No
Enumeration Date:2013-02-13
Last Update Date:2013-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX36201103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling