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Individual

DONALD GENE HODGSON

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
D.MIN. (PSYCH)

Contact information

Practice address
202 WOODFORD ST, PORTLAND, ME 04103-5602
(207) 774-8243
(207) 773-3317
Mailing address
202 WOODFORD ST, PORTLAND, ME 04103-5602
(207) 774-8243
(207) 773-3317

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC857
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
022570
PIN FOR ANTHEM BC/BS
ME
Enumeration date
01/25/2006
Last updated
07/08/2007
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