| Doctor Name: | MR. MARK GUNTHER HODGE |
| NPI Number: | 1942548060 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MS,CCC-SLP |
| License Number: | 362373-4102 |
| Business Practice Address: | 527 W 400 N Orem, UT - 840571916 |
| Business Phone Number: | 8017143505 |
| Business Fax Number: | 8017143520 |
| Mailing Address: | 331 N 400 W, OREM |
| State: | UT |
| Postal Code: | 840571913 |
| Phone Number: | 8017143505 |
| Fax Number: | 8017143520 |
| NPI Enumeration Date: | 01/24/2013 |
| NPI Last Update Date: | 01/24/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 362373-4102 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| 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 |