Healthcare Provider Details

I. General information

NPI: 1114851037
Provider Name (Legal Business Name): DEZJ'NAE HODGE RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/09/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3006 BEE CAVES RD STE B200
AUSTIN TX
78746-6751
US

IV. Provider business mailing address

3006 BEE CAVES RD STE B200
AUSTIN TX
78746-6751
US

V. Phone/Fax

Practice location:
  • Phone: 512-328-5599
  • Fax: 512-328-5585
Mailing address:
  • Phone: 512-328-5599
  • Fax: 512-328-5585

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-346757
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: