Healthcare Provider Details

I. General information

NPI: 1487963104
Provider Name (Legal Business Name): JENNIFER CAROL HODGINS M.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2010
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5221 SUNSET WALK LN
HOLLY SPRINGS NC
27540-7827
US

IV. Provider business mailing address

1709 SHELL CRACKER DR
WILLOW SPRING NC
27592-9094
US

V. Phone/Fax

Practice location:
  • Phone: 919-710-5174
  • Fax:
Mailing address:
  • Phone: 984-296-8575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number30004259
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: