Provider Demographics
NPI:1275835787
Name:HUDGENS, VALORIE ELIZABETH (LLMSW)
Entity Type:Individual
Prefix:MR
First Name:VALORIE
Middle Name:ELIZABETH
Last Name:HUDGENS
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1042 GRISWOLD ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-5867
Mailing Address - Country:US
Mailing Address - Phone:810-987-9337
Mailing Address - Fax:810-987-9548
Practice Address - Street 1:1042 GRISWOLD ST
Practice Address - Street 2:SUITE 2
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-5867
Practice Address - Country:US
Practice Address - Phone:810-987-9337
Practice Address - Fax:810-987-9548
Is Sole Proprietor?:No
Enumeration Date:2010-12-03
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801090437104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker