Provider Demographics
NPI:1306400619
Name:HUDSON, KARI DAVISON (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:DAVISON
Last Name:HUDSON
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 PENTON LINNS DR
Mailing Address - Street 2:
Mailing Address - City:ANNA
Mailing Address - State:TX
Mailing Address - Zip Code:75409-5055
Mailing Address - Country:US
Mailing Address - Phone:806-340-9057
Mailing Address - Fax:
Practice Address - Street 1:259 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-7643
Practice Address - Country:US
Practice Address - Phone:469-742-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111563235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist