Provider Demographics
NPI:1487953220
Name:NORMAN-HODGES, LARONDA (MA, PLPC)
Entity type:Individual
Prefix:MRS
First Name:LARONDA
Middle Name:
Last Name:NORMAN-HODGES
Suffix:
Gender:F
Credentials:MA, PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1855 DERHAKE RD
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-6431
Mailing Address - Country:US
Mailing Address - Phone:314-480-2775
Mailing Address - Fax:
Practice Address - Street 1:1855 DERHAKE RD
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-6431
Practice Address - Country:US
Practice Address - Phone:314-480-2775
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-18
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010029968101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional