Individual
STACY HODGES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1421 A-EAST PEACE STREET, CANTON, MS 39046-3904
(601) 855-5760
Mailing address
4109 HIGHWAY 98 W # 41, SUMMIT, MS 39666-9132
(601) 276-3900
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
TA2344
MS
Other
Enumeration date
03/20/2018
Last updated
03/20/2018
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