Provider Demographics
NPI:1548670151
Name:HODGSON, ISABEL CRISTINA (PT)
Entity type:Individual
Prefix:
First Name:ISABEL
Middle Name:CRISTINA
Last Name:HODGSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8448 SIEGEN LANE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-1938
Mailing Address - Country:US
Mailing Address - Phone:225-767-8182
Mailing Address - Fax:225-767-8757
Practice Address - Street 1:625 S BURNSIDE AVE
Practice Address - Street 2:UNIT 9
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-3400
Practice Address - Country:US
Practice Address - Phone:225-644-8510
Practice Address - Fax:225-644-9736
Is Sole Proprietor?:No
Enumeration Date:2014-05-05
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA04380F2251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic