Provider Demographics
NPI:1407181027
Name:HODGES, KATHLEEN (MA, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:
Last Name:HODGES
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:182 ILIWAI LOOP
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-7104
Mailing Address - Country:US
Mailing Address - Phone:808-868-7262
Mailing Address - Fax:
Practice Address - Street 1:1826 WILI PA LOOP STE 6
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1279
Practice Address - Country:US
Practice Address - Phone:808-856-9821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-15
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program