Doctor Name: | DOUGLAS HODGE |
NPI Number: | 1861738916 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPE |
License Number: | LPE1207 |
Business Practice Address: | 3810 Winchester Rd Memphis, TN - 381186045 |
Business Phone Number: | 9013691420 |
Business Fax Number: | 9013691433 |
Mailing Address: | 139 E Nolley Dr, COLLIERVILLE |
State: | TN |
Postal Code: | 380173553 |
Phone Number: | 9018532792 |
Fax Number: | |
NPI Enumeration Date: | 12/18/2012 |
NPI Last Update Date: | 12/18/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | LPE1207 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |