Provider Demographics
NPI:1306220017
Name:HODGE, MAGGIE JANE
Entity Type:Individual
Prefix:
First Name:MAGGIE
Middle Name:JANE
Last Name:HODGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MAGGIE
Other - Middle Name:JANE
Other - Last Name:CODY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:2838 AUTOMOTIVE CTR
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-1220
Mailing Address - Country:US
Mailing Address - Phone:989-790-7500
Mailing Address - Fax:989-790-8037
Practice Address - Street 1:2838 AUTOMOTIVE CTR
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48603-1220
Practice Address - Country:US
Practice Address - Phone:989-790-7500
Practice Address - Fax:989-790-8037
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-13
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401015527101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional