Provider Demographics
NPI:1598211989
Name:HUDSON, WOROUD ROSANNA (OTD OTR/L)
Entity Type:Individual
Prefix:DR
First Name:WOROUD
Middle Name:ROSANNA
Last Name:HUDSON
Suffix:
Gender:F
Credentials:OTD OTR/L
Other - Prefix:DR
Other - First Name:WOROUD
Other - Middle Name:ROSANNA
Other - Last Name:GNEYM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTD OTR/L
Mailing Address - Street 1:16112 WRIGHT PLZ
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68130-1839
Mailing Address - Country:US
Mailing Address - Phone:269-364-3372
Mailing Address - Fax:
Practice Address - Street 1:323 S 132ND ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-2106
Practice Address - Country:US
Practice Address - Phone:402-330-4272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-26
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA083449225X00000X
NE2010225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist