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General NPI Number Information
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NPI Number | 1891918918
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Entity Type | Organization
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Legal Business Name | DEBORAH I HODGE
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 69 OAK LANE
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City | FAIRLEE
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State | VT
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Zip | 05045
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Country | US
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Telephone | 802-333-4829
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Fax | 802-333-7091
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Provider Business Mailing Address
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Address Line | 69 OAK LANE
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City | FAIRLEE
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State | VT
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Zip | 05045
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Country | US
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Telephone | 802-333-4829
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Fax | 802-333-7091
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Authorized Official
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Title or Position | OWNER
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Name | DEBORAH I. HODGE
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Credential |
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Telephone | 802-333-4829
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | 0195
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License Number State | VT
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