| NPI | 1609280254 |
|---|---|
| Former Name | CONNIE HODGES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: KS 75726) |
| Additional Taxonomies | 103TP0016X Psychologist Prescribing (Medical) (Licence: KS 53-75726-061) |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2015-12-07 |