Provider Demographics
NPI:1093829467
Name:HUDSON, RUTH A (BS, MA, LCDC)
Entity Type:Individual
Prefix:MS
First Name:RUTH
Middle Name:A
Last Name:HUDSON
Suffix:
Gender:F
Credentials:BS, MA, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 SUNNYBROOK DR
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75061-2161
Mailing Address - Country:US
Mailing Address - Phone:972-254-3344
Mailing Address - Fax:
Practice Address - Street 1:1820 SUNNYBROOK DR
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-2161
Practice Address - Country:US
Practice Address - Phone:972-254-3344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4971324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX11915043OtherDRIVERS LICENSE