Provider Demographics
NPI:1912287228
Name:HODGES, KRISTI KAY (SLP)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:KAY
Last Name:HODGES
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:KRISTI
Other - Middle Name:KAY
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:391 COUNTY ROAD 4220
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:TX
Mailing Address - Zip Code:75455-8853
Mailing Address - Country:US
Mailing Address - Phone:936-465-5874
Mailing Address - Fax:
Practice Address - Street 1:391 COUNTY ROAD 4220
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:TX
Practice Address - Zip Code:75455-8853
Practice Address - Country:US
Practice Address - Phone:936-465-5874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-18
Last Update Date:2019-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100193235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist