Provider Demographics
NPI:1508017096
Name:JONES-HUDSON, VONDA DIONNE (PHD, MDIV)
Entity Type:Individual
Prefix:MS
First Name:VONDA
Middle Name:DIONNE
Last Name:JONES-HUDSON
Suffix:
Gender:F
Credentials:PHD, MDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1623 US HIGHWAY #1
Mailing Address - Street 2:SUITE A-6
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958-3879
Mailing Address - Country:US
Mailing Address - Phone:772-918-3166
Mailing Address - Fax:772-918-3411
Practice Address - Street 1:1623 US HIGHWAY #1
Practice Address - Street 2:SUITE A-6
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958-3879
Practice Address - Country:US
Practice Address - Phone:772-918-3166
Practice Address - Fax:772-918-3411
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-02
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY10263103TC0700X
NC3127103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical