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NPI Code Detail

MEDICARE: TYANN HODGES

MEDICARE: TYANN HODGES
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
1373H00000XDay Training/Habilitation Specialist
2374U00000XHome Health Aide

General Provider Information

NPI Number : 1205648946
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYANN HODGES
Provider Business Mailing Address
First Line : 1911 S HEIGHTS AVE
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44502-2947
Country : US
Telephone Number : 470-435-3997
Fax Number :
Provider Business Practice Location Address
First Line : 189 MADISON ST
Second Line :
City : CAMPBELL
State : OH
Zip : 44405-1834
Country : US
Telephone Number : 470-435-3997
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2025
Last Update Date : 01/21/2025

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Directions to “ TYANN HODGES ” Practice Location

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