Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner | 2006 S | NV |
NPI | 1053473777 |
---|---|
Provider Name | Kathy Hodge |
First Address | Reno, NV 89511-7779 |
Second Address | Reno, NV 89511-7779 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2006 |
Last Update Date | 05/04/2011 |