Provider Demographics
NPI:1033817689
Name:HUDSON, KYLA CHEMILLE
Entity Type:Individual
Prefix:MS
First Name:KYLA
Middle Name:CHEMILLE
Last Name:HUDSON
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:DEPT OF SOCIAL WORK-OPIOID IMPACTED FAMILY SUPPORT
Mailing Address - Street 2:104 BUCHANAN HALL
Mailing Address - City:NORMAL
Mailing Address - State:AL
Mailing Address - Zip Code:35762
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:DEPT OF SOCIAL WORK-OPIOID IMPACTED FAMILY SUPPORT
Practice Address - Street 2:104 BUCHANAN HALL
Practice Address - City:NORMAL
Practice Address - State:AL
Practice Address - Zip Code:35762
Practice Address - Country:US
Practice Address - Phone:205-381-2292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-22
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker