Provider Demographics
NPI:1659418440
Name:HODGSON, HILARY ELLEN (PHD)
Entity Type:Individual
Prefix:
First Name:HILARY
Middle Name:ELLEN
Last Name:HODGSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 COPPERSTONE TRL
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-7562
Mailing Address - Country:US
Mailing Address - Phone:469-549-0486
Mailing Address - Fax:
Practice Address - Street 1:4100 MERRELL RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75229-6217
Practice Address - Country:US
Practice Address - Phone:214-353-5777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31746103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical