Provider Demographics
NPI:1124037239
Name:HODGSON, VALERIE (PT DPT)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:HODGSON
Suffix:
Gender:F
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1255
Mailing Address - Street 2:
Mailing Address - City:NORTH DIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02764-0826
Mailing Address - Country:US
Mailing Address - Phone:508-822-1135
Mailing Address - Fax:508-822-4115
Practice Address - Street 1:600 OLD SOMERSET AVE
Practice Address - Street 2:UNIT 2
Practice Address - City:NORTH DIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02764-1255
Practice Address - Country:US
Practice Address - Phone:508-822-1135
Practice Address - Fax:508-822-4115
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8950225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY68778Medicare PIN