Provider Demographics
NPI:1659603991
Name:HUDGENS, DOROTHY M (RN,BSN,LMSW,LSCSW)
Entity Type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:M
Last Name:HUDGENS
Suffix:
Gender:F
Credentials:RN,BSN,LMSW,LSCSW
Other - Prefix:MS
Other - First Name:DEE
Other - Middle Name:M
Other - Last Name:HUDGENS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN,BSN,LMSW,LSCSW
Mailing Address - Street 1:2304 W COTHRELL ST
Mailing Address - Street 2:
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-6825
Mailing Address - Country:US
Mailing Address - Phone:913-205-6340
Mailing Address - Fax:
Practice Address - Street 1:2304 W COTHRELL ST
Practice Address - Street 2:
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-6825
Practice Address - Country:US
Practice Address - Phone:913-205-6340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS6931101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional