Provider Demographics
NPI:1790377794
Name:HODGES, GABRIELLE MONIQUE (LISW)
Entity type:Individual
Prefix:MS
First Name:GABRIELLE
Middle Name:MONIQUE
Last Name:HODGES
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3500 EXECUTIVE PKWY
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-1319
Mailing Address - Country:US
Mailing Address - Phone:567-585-5337
Mailing Address - Fax:567-585-5336
Practice Address - Street 1:3500 EXECUTIVE PKWY
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-1319
Practice Address - Country:US
Practice Address - Phone:567-585-5337
Practice Address - Fax:567-585-5336
Is Sole Proprietor?:No
Enumeration Date:2021-02-10
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.2506430104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker