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General NPI Number Information
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NPI Number | 1346730793
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Entity Type | Individual
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Provider Name | JENNIFER HODGSON PSYD
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Gender | Female
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Dates
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Enumeration Date | 05/11/2018
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Last Update Date | 09/14/2020
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Provider Practice Location Address
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Address Line | 10555 MARTY ST STE 100
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City | OVERLAND PARK
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State | KS
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Zip | 66212-2555
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Country | US
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Telephone | 913-649-8820
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Fax | 913-649-8823
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Provider Business Mailing Address
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Address Line | 10555 MARTY ST STE 100
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City | OVERLAND PARK
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State | KS
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Zip | 66212-2555
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Country | US
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Telephone | 913-649-8820
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Fax | 913-649-8823
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | TLP4983
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | LP2890
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License Number State | KS
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