Provider Demographics
NPI:1124592175
Name:HODGES, LAURA (LMFT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:HODGES
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:RIVER FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54022-2403
Mailing Address - Country:US
Mailing Address - Phone:651-504-2483
Mailing Address - Fax:
Practice Address - Street 1:710 N MAIN ST STE 204
Practice Address - Street 2:
Practice Address - City:RIVER FALLS
Practice Address - State:WI
Practice Address - Zip Code:54022-3605
Practice Address - Country:US
Practice Address - Phone:651-504-2483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-13
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3438106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist