Provider Demographics
NPI:1255785259
Name:HODGES, ROMILLY (MS CNS)
Entity type:Individual
Prefix:
First Name:ROMILLY
Middle Name:
Last Name:HODGES
Suffix:
Gender:F
Credentials:MS CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 GLEN RD
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:SANDY HOOK
Mailing Address - State:CT
Mailing Address - Zip Code:06482-1193
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:27 GLEN RD
Practice Address - Street 2:4TH FLOOR
Practice Address - City:SANDY HOOK
Practice Address - State:CT
Practice Address - Zip Code:06482-1193
Practice Address - Country:US
Practice Address - Phone:203-304-9502
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-16
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist