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NPI Code Detail

MEDICARE: RAHEL HODGE LCSW

MEDICARE:   RAHEL  HODGE  LCSW
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
11041C0700XClinical Social WorkerLCSW-17214AZ

General Provider Information

NPI Number : 1386293017
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAHEL HODGE LCSW
Provider Business Mailing Address
First Line : 1438 E REDFIELD RD
Second Line :
City : GILBERT
State : AZ
Zip : 85234-4870
Country : US
Telephone Number : 480-735-1233
Fax Number :
Provider Business Practice Location Address
First Line : 2563 S VAL VISTA DR STE 108
Second Line :
City : GILBERT
State : AZ
Zip : 85295-6231
Country : US
Telephone Number : 480-448-1076
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/05/2019
Last Update Date : 01/24/2020

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