Provider Demographics
NPI:1275675373
Name:HUDSON, ANTONIA JAMILA (MA)
Entity Type:Individual
Prefix:MS
First Name:ANTONIA
Middle Name:JAMILA
Last Name:HUDSON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4572 APPLEGATE RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38109-5810
Mailing Address - Country:US
Mailing Address - Phone:901-789-1960
Mailing Address - Fax:901-789-4601
Practice Address - Street 1:2890 BEKEMEYER DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TN
Practice Address - Zip Code:38002-9522
Practice Address - Country:US
Practice Address - Phone:901-252-7240
Practice Address - Fax:901-252-7280
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health