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NPI Code Detail

MEDICARE: MRS. DEBRA ANN HODGE

MEDICARE:  MRS. DEBRA ANN HODGE
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 Attendant1805541OH

General Provider Information

NPI Number : 1972106714
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DEBRA ANN HODGE
Provider Business Mailing Address
First Line : 3309 BERKELEY RD
Second Line :
City : CLEVELAND HTS
State : OH
Zip : 44118-2056
Country : US
Telephone Number : 121-650-9516
Fax Number : 216-932-5089
Provider Business Practice Location Address
First Line : 3309 BERKELEY RD
Second Line :
City : CLEVELAND HTS
State : OH
Zip : 44118-2056
Country : US
Telephone Number : 216-509-5165
Fax Number : 216-932-5089
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2020
Last Update Date : 11/16/2020

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Directions to “ MRS. DEBRA ANN HODGE ” Practice Location

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