Organization
CCPCS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAMARA LYNN HODGES (PSYCHOLOGIST)
(254) 776-7792
Entity
Organization
Contact information
Practice address
305 LONDONDERRY DR STE 7, WACO, TX 76712-7906
(254) 776-7792
(254) 776-0577
Mailing address
305 LONDONDERRY DR STE 7, WACO, TX 76712-7906
(254) 776-7792
(254) 776-0577
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2-5171
TX
Other
Enumeration date
10/01/2009
Last updated
10/01/2009
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