Provider Demographics
NPI:1417055757
Name:HUDSON, CAROLINE ALEXANDER (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:CAROLINE
Middle Name:ALEXANDER
Last Name:HUDSON
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:CAROLINE
Other - Last Name:ALEXANDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:122 MORNING DOVE DRIVE
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-6518
Mailing Address - Country:US
Mailing Address - Phone:270-793-9987
Mailing Address - Fax:270-780-6177
Practice Address - Street 1:122 MORNING DOVE DRIVE
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-6518
Practice Address - Country:US
Practice Address - Phone:270-793-9987
Practice Address - Fax:270-780-6177
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2323235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1531OtherPROVIDER NUMBER