Doctor Name: | KATHLEEN HODGKISS |
NPI Number: | 1013179233 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD |
License Number: | 018223 |
Business Practice Address: | 385 Tremont Ave East Orange, NJ - 070181023 |
Business Phone Number: | 9736761000 |
Business Fax Number: | |
Mailing Address: | 223 Lakeside Ave, POMPTON LAKES |
State: | NJ |
Postal Code: | 074421226 |
Phone Number: | 9736161754 |
Fax Number: | |
NPI Enumeration Date: | 06/29/2008 |
NPI Last Update Date: | 03/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 018223 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |