Provider Demographics
NPI:1033355078
Name:DODDS, AMY (PHD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:
Last Name:DODDS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:886 JOHNNIE DODDS BLVD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3190
Mailing Address - Country:US
Mailing Address - Phone:843-881-6511
Mailing Address - Fax:843-416-1153
Practice Address - Street 1:886 JOHNNIE DODDS BLVD
Practice Address - Street 2:SUITE 202
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3190
Practice Address - Country:US
Practice Address - Phone:843-881-6511
Practice Address - Fax:843-416-1153
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-22
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC683103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical