Provider Demographics
NPI:1780908764
Name:HODGES, JUDITH (MA)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:
Last Name:HODGES
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 STORM CT
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27513-4153
Mailing Address - Country:US
Mailing Address - Phone:919-862-3432
Mailing Address - Fax:
Practice Address - Street 1:419 N BOYLAN AVE STE 101
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-1264
Practice Address - Country:US
Practice Address - Phone:919-747-9843
Practice Address - Fax:919-747-9845
Is Sole Proprietor?:No
Enumeration Date:2010-03-20
Last Update Date:2010-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)