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General NPI Number Information
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NPI Number | 1841087582
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Entity Type | Individual
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Provider Name | RODMAN HODGES
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Gender | Male
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Dates
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Enumeration Date | 04/24/2025
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 6309 MACK AVE
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City | DETROIT
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State | MI
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Zip | 48207-2302
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Country | US
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Telephone | 313-467-0086
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Fax |
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Provider Business Mailing Address
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Address Line | 16648 CRUSE ST
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City | DETROIT
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State | MI
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Zip | 48235-4096
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Country | US
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Telephone | 313-467-6741
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6851110125
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License Number State | MI
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