Individual
MRS. HOLLY JO HODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
309 S GLENN AVE, COLTON, SD 57018-2108
(605) 359-9882
Mailing address
309 S GLENN AVE, COLTON, SD 57018-2108
(605) 359-9882
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
185A
SD
Other
Enumeration date
10/02/2007
Last updated
10/02/2007
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