Provider Demographics
NPI:1700053808
Name:HODGE, ELIZABETH G (MSP,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:G
Last Name:HODGE
Suffix:
Gender:F
Credentials:MSP,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2502 S NC HIGHWAY 119
Mailing Address - Street 2:
Mailing Address - City:MEBANE
Mailing Address - State:NC
Mailing Address - Zip Code:27302-9565
Mailing Address - Country:US
Mailing Address - Phone:336-578-5815
Mailing Address - Fax:336-578-7269
Practice Address - Street 1:2502 S NC HIGHWAY 119
Practice Address - Street 2:
Practice Address - City:MEBANE
Practice Address - State:NC
Practice Address - Zip Code:27302-9565
Practice Address - Country:US
Practice Address - Phone:336-578-5815
Practice Address - Fax:336-578-7269
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7475235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist