Provider Demographics
NPI:1972841831
Name:DODSON, VALERIE JO RENA
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:JO RENA
Last Name:DODSON
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 1:36972 COUNTY ROAD 1640
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:OK
Mailing Address - Zip Code:74572-6005
Mailing Address - Country:US
Mailing Address - Phone:580-927-0022
Mailing Address - Fax:
Practice Address - Street 1:705 W 13TH ST
Practice Address - Street 2:
Practice Address - City:ATOKA
Practice Address - State:OK
Practice Address - Zip Code:74525-3712
Practice Address - Country:US
Practice Address - Phone:580-889-5555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-27
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator