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General NPI Number Information
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NPI Number | 1689400376
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Entity Type | Individual
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Provider Name | BAILEY JANE HODSON
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Gender | Female
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Dates
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Enumeration Date | 09/10/2024
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Last Update Date | 09/10/2024
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Provider Practice Location Address
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Address Line | 4370 114TH ST
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City | URBANDALE
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State | IA
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Zip | 50322-5408
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Country | US
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Telephone | 515-219-7999
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Fax |
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Provider Business Mailing Address
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Address Line | 916 SE ROSEWOOD LN UNIT 31
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City | GRIMES
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State | IA
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Zip | 50111-4267
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Country | US
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Telephone | 515-779-3007
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Fax | 515-779-3007
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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