Provider Demographics
NPI:1457835308
Name:HUDSON, TERRIE LYNN (CSAC)
Entity Type:Individual
Prefix:
First Name:TERRIE
Middle Name:LYNN
Last Name:HUDSON
Suffix:
Gender:F
Credentials:CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 823
Mailing Address - Street 2:
Mailing Address - City:DOBSON
Mailing Address - State:NC
Mailing Address - Zip Code:27017-0823
Mailing Address - Country:US
Mailing Address - Phone:336-648-4141
Mailing Address - Fax:
Practice Address - Street 1:113 N CRUTCHFIELD ST
Practice Address - Street 2:
Practice Address - City:DOBSON
Practice Address - State:NC
Practice Address - Zip Code:27017-8804
Practice Address - Country:US
Practice Address - Phone:336-648-4141
Practice Address - Fax:336-352-3635
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-17
Last Update Date:2018-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15661101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor