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NPI Code Detail

MEDICARE: TESSA DANYELE HODGSON

MEDICARE:   TESSA DANYELE HODGSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1013527373
Entity Type Code : Individual
Provider Name (Legal Business Name) : TESSA DANYELE HODGSON
Provider Business Mailing Address
First Line : 49 PEACH TREE LN
Second Line :
City : BUNKER HILL
State : WV
Zip : 25413-3166
Country : US
Telephone Number : 540-303-4334
Fax Number :
Provider Business Practice Location Address
First Line : 49 PEACH TREE LN
Second Line :
City : BUNKER HILL
State : WV
Zip : 25413-3166
Country : US
Telephone Number : 540-303-4334
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2020
Last Update Date : 07/07/2021

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Directions to “ TESSA DANYELE HODGSON ” Practice Location

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