Provider Demographics
NPI:1467581033
Name:HODGDON, CATHERINE GRACE (LMT)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:GRACE
Last Name:HODGDON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 HAMPSTEAD RD # B
Mailing Address - Street 2:
Mailing Address - City:DERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03038-7033
Mailing Address - Country:US
Mailing Address - Phone:603-434-9718
Mailing Address - Fax:
Practice Address - Street 1:8 STILES RD
Practice Address - Street 2:SUITE 107
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2847
Practice Address - Country:US
Practice Address - Phone:603-890-9996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2366M171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor