Provider Demographics
NPI:1619639309
Name:HUDZIK, COURTNEY NICOLE (MS OTR/L)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:NICOLE
Last Name:HUDZIK
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:775 E WOOD ST
Mailing Address - Street 2:
Mailing Address - City:LOWELLVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44436-1260
Mailing Address - Country:US
Mailing Address - Phone:330-787-2813
Mailing Address - Fax:
Practice Address - Street 1:2728 WARREN BURTON RD
Practice Address - Street 2:
Practice Address - City:SOUTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:44470-9742
Practice Address - Country:US
Practice Address - Phone:330-307-4659
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-10
Last Update Date:2021-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist