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NPI Code Detail

MEDICARE: KRISTIN B HODSON CSW

MEDICARE: KRISTIN B HODSON CSW
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 Worker6217132-3502UT

General Provider Information

NPI Number : 1497844955
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIN B HODSON CSW
Provider Business Mailing Address
First Line : 4623 PARK MANOR DR
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84117-4226
Country : US
Telephone Number : 801-808-0636
Fax Number :
Provider Business Practice Location Address
First Line : 1670 E. 1300 E.
Second Line : SUITE 204
City : SLC
State : UT
Zip : 84105
Country : US
Telephone Number : 801-808-0636
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2006
Last Update Date : 07/28/2009

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Directions to “ KRISTIN B HODSON CSW” Practice Location

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