Stacey Anne Hodges, OTRL

Individual provider Active NPI Occupational Therapist · Vinton, IA

NPI 1962549030 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1962549030
Entity type
Individual (NPI type 1)
Primary specialty
Occupational Therapist 225X00000X
License
01036 (IA)
Practice address
502 N 9TH Ave
Vinton, IA 52349-2254
Phone
(319) 472-6372
Fax
(319) 472-6222
NPI assigned
Jan 30, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
01036IAMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 01036 IA Yes

Addresses

Primary practice location

502 N 9TH Ave
Vinton, IA 52349-2254

Mailing address

502 N 9TH Ave
Vinton, IA 52349-2254
Phone (319) 472-6372

Other identifiers

IdentifierTypeStateIssuer
36297OtherIAWELLMARK BLUE CROSS

Other providers in Vinton, IA

All providers in Vinton, IA · Occupational Therapist in Iowa

Sources for this page

Verify at the official NPI Registry.