Provider Demographics
NPI:1841841806
Name:HODGDON, SHARON GARCIA (BCBA)
Entity type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:GARCIA
Last Name:HODGDON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MS
Other - First Name:SHARON
Other - Middle Name:
Other - Last Name:GARCIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:43 SUMMERHILL RD
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-3464
Mailing Address - Country:US
Mailing Address - Phone:860-514-2337
Mailing Address - Fax:
Practice Address - Street 1:5 BARNES INDUSTRIAL RD S
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-2431
Practice Address - Country:US
Practice Address - Phone:203-284-0441
Practice Address - Fax:203-284-5716
Is Sole Proprietor?:No
Enumeration Date:2019-09-21
Last Update Date:2019-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT17103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst