Provider Demographics
NPI:1376298075
Name:HODGSON, ALEXA DANIELLE
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:DANIELLE
Last Name:HODGSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 MARINERS PLAZA DR STE 509
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70448-6856
Mailing Address - Country:US
Mailing Address - Phone:985-260-1473
Mailing Address - Fax:
Practice Address - Street 1:500 MARINERS PLAZA DR STE 509
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70448-6856
Practice Address - Country:US
Practice Address - Phone:985-260-1473
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-21
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst