Provider Demographics
NPI:1083898878
Name:HUDDLESTON, JO ANN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:JO
Middle Name:ANN
Last Name:HUDDLESTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 ROGERS DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-2054
Mailing Address - Country:US
Mailing Address - Phone:205-870-3520
Mailing Address - Fax:205-263-0311
Practice Address - Street 1:2700 ROGERS DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35209-2054
Practice Address - Country:US
Practice Address - Phone:205-870-3520
Practice Address - Fax:205-263-0311
Is Sole Proprietor?:No
Enumeration Date:2007-12-28
Last Update Date:2007-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1136101YP2500X
AL1996B1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical