Provider Demographics
NPI:1437126729
Name:DODD, ANNETTE K (LCSW)
Entity type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:K
Last Name:DODD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:ANN
Other - Middle Name:K
Other - Last Name:DODD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:6576 104TH ST
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-3307
Mailing Address - Country:US
Mailing Address - Phone:808-724-4422
Mailing Address - Fax:
Practice Address - Street 1:ARMY DESMOND DOSS HEALTH CLINIC
Practice Address - Street 2:683 WAIANAE AVE BLDG G 2ND FLOOR
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786
Practice Address - Country:US
Practice Address - Phone:808-724-4422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-05
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA223111041C0700X
CALCS 223111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical