Provider Demographics
NPI:1942932470
Name:HODKIEWICZ, DANIELE ERIN (SW)
Entity Type:Individual
Prefix:
First Name:DANIELE
Middle Name:ERIN
Last Name:HODKIEWICZ
Suffix:
Gender:F
Credentials:SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6333 ODANA RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-1170
Mailing Address - Country:US
Mailing Address - Phone:608-438-6928
Mailing Address - Fax:
Practice Address - Street 1:54 S JACKSON ST
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53548-3837
Practice Address - Country:US
Practice Address - Phone:608-225-2108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13451-120104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker