Provider Demographics
NPI:1073394540
Name:HUDSON, LABRITTINI (BT)
Entity Type:Individual
Prefix:
First Name:LABRITTINI
Middle Name:
Last Name:HUDSON
Suffix:
Gender:F
Credentials:BT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3912 SOUTHERN OAKS DR UNIT 4
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28314-1176
Mailing Address - Country:US
Mailing Address - Phone:910-354-4170
Mailing Address - Fax:
Practice Address - Street 1:201 S MCPHERSON CHURCH RD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-4974
Practice Address - Country:US
Practice Address - Phone:910-691-4343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty