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General NPI Number Information
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NPI Number | 1841915972
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Entity Type | Individual
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Provider Name | SAMANTHA RAE LEE-HODGES PH.D., LP
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Gender | Female
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Dates
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Enumeration Date | 10/11/2022
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Last Update Date | 10/11/2022
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Provider Practice Location Address
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Address Line | 501 28TH ST
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City | DENVER
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State | CO
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Zip | 80205-3003
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Country | US
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Telephone | 303-602-6333
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Fax |
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Provider Business Mailing Address
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Address Line | 601 N BROADWAY # MC1926
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City | DENVER
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State | CO
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Zip | 80203-3407
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 3919-57
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY.0005787
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License Number State | CO
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