Provider Demographics
NPI:1558942359
Name:HODGES, ALEECIA ROSHELLE (BIRTH DOULA)
Entity Type:Individual
Prefix:MRS
First Name:ALEECIA
Middle Name:ROSHELLE
Last Name:HODGES
Suffix:
Gender:F
Credentials:BIRTH DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2618 NE 86TH AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220-5482
Mailing Address - Country:US
Mailing Address - Phone:503-753-8511
Mailing Address - Fax:
Practice Address - Street 1:2618 NE 86TH AVE UNIT B
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-5482
Practice Address - Country:US
Practice Address - Phone:503-753-8511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula