Provider Demographics
NPI:1407866361
Name:HUDGINS, TAMARA MICHELE (BA)
Entity Type:Individual
Prefix:MRS
First Name:TAMARA
Middle Name:MICHELE
Last Name:HUDGINS
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 E HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:OK
Mailing Address - Zip Code:74873-9714
Mailing Address - Country:US
Mailing Address - Phone:405-598-9479
Mailing Address - Fax:
Practice Address - Street 1:126 N BELL AVE
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74801-6902
Practice Address - Country:US
Practice Address - Phone:405-275-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health