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General NPI Number Information
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NPI Number | 1932674454
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Entity Type | Individual
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Provider Name | KIMBERLY BLANDING HODGES ED.D.
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Gender | Female
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Dates
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Enumeration Date | 10/11/2018
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Last Update Date | 10/11/2018
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Provider Practice Location Address
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Address Line | 3848 FLATIRON LOOP UNIT 102
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-7825
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Country | US
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Telephone | 813-703-1846
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Fax |
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Provider Business Mailing Address
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Address Line | 20935 LAKE TALIA BLVD
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City | LAND O LAKES
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State | FL
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Zip | 34638-3703
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Country | US
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Telephone | 813-484-6553
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | SS847
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License Number State | FL
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