Eliza Ruth Dodge | Watertown, MA • PECOS Search

Eliza Ruth Dodge

Counselor

Behavioral Health & Social Service Providers

204 Arsenal St Apt 253, Watertown, MA 02472-2797

PECOS Enrollment

Based on the most recent information from CMS, provider Eliza Ruth Dodge does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1255928669
Provider Type
Individual
Full Name
Dodge, Eliza Ruth
Gender
Female

Sole Proprietor
No
Enumeration Date
12/31/2020
Last Updated
12/31/2020

Contact Information

Practice Location

204 Arsenal St Apt 253, Watertown, MA 02472-2797

Unlisted Fax

Mailing Location

520 Dudley St, Roxbury, MA 02119-2769

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YM0800X Primary	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer