Individual
KRISTEN HODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
47818 VAN DYKE AVE, SHELBY TWP, MI 48317-3373
(248) 270-5795
Mailing address
47818 VAN DYKE AVE, SHELBY TWP, MI 48317-3373
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6361007517
MI
Other
Enumeration date
05/11/2023
Last updated
05/11/2023
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