Individual
STACEY HODGDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
53 PERIMETER CTR E STE 550, ATLANTA, GA 30346-2228
(770) 822-9115
(770) 822-9457
Mailing address
53 PERIMETER CTR E STE 550, ATLANTA, GA 30346-2228
(770) 822-9115
(770) 822-9457
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-16-23695
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-16-23695
DEGREE
CA
Enumeration date
12/16/2018
Last updated
12/16/2018
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