Individual
MS. DIANE M HODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAPC
Contact information
Practice address
250 NORTH AVE, ATHENS, GA 30601-2244
(855) 333-9544
Mailing address
250 NORTH AVE, ATHENS, GA 30601-2244
(855) 333-9544
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
APC005889
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0318
—
GA
Enumeration date
11/18/2019
Last updated
11/18/2019
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