Individual
JACQUELINE HODGES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15404 ILENE ST, DETROIT, MI 48238-1042
(313) 316-6357
Mailing address
16845 LINWOOD ST, DETROIT, MI 48221-3126
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
4704305533
MI
Other
Enumeration date
12/19/2018
Last updated
12/19/2018
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