Provider Demographics
NPI:1629723259
Name:HUDSON, SHARROLD DENISE (MFT-ASSOCIATE)
Entity Type:Individual
Prefix:MS
First Name:SHARROLD
Middle Name:DENISE
Last Name:HUDSON
Suffix:
Gender:F
Credentials:MFT-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 STOUTS RD UNIT 981
Mailing Address - Street 2:
Mailing Address - City:FULTONDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35068-5036
Mailing Address - Country:US
Mailing Address - Phone:205-617-5399
Mailing Address - Fax:
Practice Address - Street 1:572 FULTONBROOK DR
Practice Address - Street 2:
Practice Address - City:FULTONDALE
Practice Address - State:AL
Practice Address - Zip Code:35068-1374
Practice Address - Country:US
Practice Address - Phone:205-617-5399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-11
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALA272106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist