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General NPI Number Information
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NPI Number | 1598403156
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Entity Type | Individual
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Provider Name | EPIPHANY HODGE SLP-A
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Gender | Female
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Dates
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Enumeration Date | 05/24/2022
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 5555 N LAMAR BLVD STE E
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City | AUSTIN
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State | TX
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Zip | 78751-1073
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Country | US
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Telephone | 214-736-8376
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Fax |
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Provider Business Mailing Address
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Address Line | 11370 BULL HEAD LN
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City | ROANOKE
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State | TX
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Zip | 76262-1909
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Country | US
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Telephone |
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Fax |
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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 | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2355S0801X
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Taxonomy Name | Speech-Language Assistant
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License Number | 42469
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License Number State | TX
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