Individual
MR. MARK GUNTHER HODGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS,CCC-SLP
Contact information
Practice address
527 W 400 N, OREM, UT 84057-1916
(801) 714-3505
(801) 714-3520
Mailing address
331 N 400 W, OREM, UT 84057-1913
(801) 714-3505
(801) 714-3520
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
362373-4102
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
870269232033
—
UT
Enumeration date
01/24/2013
Last updated
01/24/2013
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