Individual
MS. HALEY HODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1634 SALADINO ST SE, PALM BAY, FL 32909-5425
(833) 684-5439
(321) 286-3020
Mailing address
4819 CHASTAIN DR, MELBOURNE, FL 32940-1277
(321) 298-9775
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
OTA 11471
FL
225X00000X
Occupational Therapist
Primary
OT25579
FL
Other
Enumeration date
09/23/2014
Last updated
09/05/2024
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