Individual
TIERRA DAWN HODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDCA 1
Contact information
Practice address
1221 1ST AVE, MIDDLETOWN, OH 45044-4194
(513) 849-2081
Mailing address
1221 1ST AVE, MIDDLETOWN, OH 45044-4194
(513) 540-9449
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
176409
OH
Other
Enumeration date
05/03/2021
Last updated
05/03/2021
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