Provider Demographics
NPI:1609103639
Name:HUDGINS, KRISTIN (LMT)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:HUDGINS
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:
Other - Last Name:WEYANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:7054 E COCHISE RD
Mailing Address - Street 2:SUITE B100
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85253
Mailing Address - Country:US
Mailing Address - Phone:602-561-7000
Mailing Address - Fax:
Practice Address - Street 1:7054 E COCHISE RD
Practice Address - Street 2:SUITE B100
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85253
Practice Address - Country:US
Practice Address - Phone:602-561-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-12
Last Update Date:2015-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZMT-08253225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist