Provider Demographics
NPI:1679978217
Name:HUDSON, MARTHA
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:
Last Name:HUDSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 WASHINGTON BLD
Mailing Address - Street 2:UNIT 111
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06902
Mailing Address - Country:US
Mailing Address - Phone:914-486-6760
Mailing Address - Fax:
Practice Address - Street 1:101 WASHINGTON BLD
Practice Address - Street 2:UNIT 111
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-6825
Practice Address - Country:US
Practice Address - Phone:914-486-6760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor