Provider Demographics
NPI:1407457849
Name:HODGES, MELODEE KIM
Entity Type:Individual
Prefix:
First Name:MELODEE
Middle Name:KIM
Last Name:HODGES
Suffix:
Gender:F
Credentials:
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 1221
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02339-1009
Mailing Address - Country:US
Mailing Address - Phone:603-249-6807
Mailing Address - Fax:
Practice Address - Street 1:769 PLAIN ST STE I
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:MA
Practice Address - Zip Code:02050-2147
Practice Address - Country:US
Practice Address - Phone:800-852-2844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-03
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor