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NPI Code Detail

MEDICARE: JADE HODGES CCC-SLP

MEDICARE: JADE HODGES CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language PathologistSLP010141GA

General Provider Information

NPI Number : 1184331183
Entity Type Code : Individual
Provider Name (Legal Business Name) : JADE HODGES CCC-SLP
Provider Business Mailing Address
First Line : 4212 CORAL PARK DR
Second Line :
City : BRUNSWICK
State : GA
Zip : 31520-3016
Country : US
Telephone Number : 912-342-8875
Fax Number : 912-342-8016
Provider Business Practice Location Address
First Line : 1110 S PIERCE ST STE A
Second Line :
City : ALMA
State : GA
Zip : 31510-3718
Country : US
Telephone Number : 912-342-8875
Fax Number : 912-342-8016
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2022
Last Update Date : 10/31/2022

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Directions to “ JADE HODGES CCC-SLP” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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