Doctor Name: | KRISTIN DANIELLE HODGE |
NPI Number: | 1699038117 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA CCC-SLP |
License Number: | 22005201A |
Business Practice Address: | 1800 N Wabash Rd Ste 203 Marion, IN - 469521300 |
Business Phone Number: | 7656513229 |
Business Fax Number: | |
Mailing Address: | Po Box 257, SWEETSER |
State: | IN |
Postal Code: | 469870257 |
Phone Number: | 7656182023 |
Fax Number: | |
NPI Enumeration Date: | 06/19/2012 |
NPI Last Update Date: | 06/19/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 22005201A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |