Provider Demographics
NPI:1770899692
Name:HODGES, RAYSHONE (PSYD)
Entity type:Individual
Prefix:DR
First Name:RAYSHONE
Middle Name:
Last Name:HODGES
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15504 NEWTONMORE LN
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-8855
Mailing Address - Country:US
Mailing Address - Phone:202-421-7295
Mailing Address - Fax:301-358-2124
Practice Address - Street 1:15504 NEWTONMORE LN
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-8855
Practice Address - Country:US
Practice Address - Phone:202-421-7295
Practice Address - Fax:301-358-2124
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-30
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist