Individual
DANIELLE HODGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
747 E EIGHTH ST, TRAVERSE CITY, MI 49686-2662
(231) 346-5216
Mailing address
747 E 8TH ST, TRAVERSE CITY, MI 49686-2662
(231) 346-5216
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
4704330513
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07051980
—
MI
Enumeration date
04/07/2022
Last updated
04/07/2022
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