Provider Demographics
NPI:1609644236
Name:HODGKINS, EBONIE (RBT)
Entity Type:Individual
Prefix:
First Name:EBONIE
Middle Name:
Last Name:HODGKINS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 TRIMMIER RD STE A4-A5
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76541-8521
Mailing Address - Country:US
Mailing Address - Phone:254-294-4488
Mailing Address - Fax:512-569-6547
Practice Address - Street 1:1801 TRIMMIER RD STE A4-A5
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76541-8521
Practice Address - Country:US
Practice Address - Phone:254-294-4488
Practice Address - Fax:512-569-6547
Is Sole Proprietor?:No
Enumeration Date:2023-12-13
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician