Individual
JEQUITA HODGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9314 E OUTER DR, DETROIT, MI 48213-4009
(248) 678-5147
Mailing address
PO BOX 3481, HIGHLAND PARK, MI 48203-0481
(248) 678-5147
Taxonomy
Speciality
Code
Description
License number
State
372500000X
Chore Provider
000000000
MI
372500000X
Chore Provider
1000-05
—
372500000X
Chore Provider
Primary
—
MI
Other
Enumeration date
03/22/2024
Last updated
03/22/2024
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