Healthcare Provider Details

I. General information

NPI: 1477046167
Provider Name (Legal Business Name): MISS BREANNA LYNN HODGINS-VOLK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2018
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1759 W YOUNGS DITCH RD
BAY CITY MI
48708-9173
US

IV. Provider business mailing address

3727 WILDER RD
BAY CITY MI
48706-2367
US

V. Phone/Fax

Practice location:
  • Phone: 989-209-3250
  • Fax:
Mailing address:
  • Phone: 989-992-3497
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: