Provider Demographics
NPI:1306969704
Name:HODGES, MARGARET A (PSYD)
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:A
Last Name:HODGES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:MEG
Other - Middle Name:
Other - Last Name:HODGES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:PO BOX 72
Mailing Address - Street 2:
Mailing Address - City:CONIFER
Mailing Address - State:CO
Mailing Address - Zip Code:80433-0072
Mailing Address - Country:US
Mailing Address - Phone:510-282-8953
Mailing Address - Fax:
Practice Address - Street 1:6949 HIGHWAY 73 STE 11
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-6238
Practice Address - Country:US
Practice Address - Phone:510-282-8953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CO0004055103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty