Provider Demographics
NPI:1689400376
Name:HODSON, BAILEY JANE
Entity type:Individual
Prefix:
First Name:BAILEY
Middle Name:JANE
Last Name:HODSON
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 1:916 SE ROSEWOOD LN UNIT 31
Mailing Address - Street 2:
Mailing Address - City:GRIMES
Mailing Address - State:IA
Mailing Address - Zip Code:50111-4267
Mailing Address - Country:US
Mailing Address - Phone:515-779-3007
Mailing Address - Fax:515-779-3007
Practice Address - Street 1:4370 114TH ST
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-5408
Practice Address - Country:US
Practice Address - Phone:515-219-7999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-10
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician