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1255846168
MARY HODGE
ROSEVILLE, MN
NPI
1255846168
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MN 303575)
Enumeration Date
2017-12-14
Last Update Date
2017-12-14
Business Address
MARY HODGE
2311 WOODBRIDGE ST
ROSEVILLE, MN 55113-4710
Phone number: 651-773-0832
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Mailing Address
MARY HODGE
2311 WOODBRIDGE ST
ROSEVILLE, MN 55113-4710
Phone number: 651-773-0832
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