Provider Demographics
NPI:1073107413
Name:HODSON, MARIANNE (LIMHP, MSW)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:
Last Name:HODSON
Suffix:
Gender:F
Credentials:LIMHP, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13023 BINNEY ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-4249
Mailing Address - Country:US
Mailing Address - Phone:402-965-9925
Mailing Address - Fax:
Practice Address - Street 1:450 E 23RD ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-2303
Practice Address - Country:US
Practice Address - Phone:402-941-7861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-25
Last Update Date:2021-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2164101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health