Provider Demographics
NPI:1528199460
Name:HUDSON-SNIPES, ROCHEL NYTHOSIA
Entity Type:Individual
Prefix:
First Name:ROCHEL
Middle Name:NYTHOSIA
Last Name:HUDSON-SNIPES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ROCHEL
Other - Middle Name:NYTHOSIA
Other - Last Name:HUDSON-SNIPES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW-CP
Mailing Address - Street 1:130 WHITEFORD WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-7617
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:130 WHITEFORD WAY
Practice Address - Street 2:SUITE A
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072
Practice Address - Country:US
Practice Address - Phone:803-808-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC70841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical