Provider Demographics
NPI:1770828253
Name:HUDSON, SHAYLA DENE
Entity Type:Individual
Prefix:MS
First Name:SHAYLA
Middle Name:DENE
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 1:9471 CEDARVIEW LN
Mailing Address - Street 2:
Mailing Address - City:GUTHRIE
Mailing Address - State:OK
Mailing Address - Zip Code:73044-6863
Mailing Address - Country:US
Mailing Address - Phone:405-824-2320
Mailing Address - Fax:
Practice Address - Street 1:9471 CEDARVIEW LN
Practice Address - Street 2:
Practice Address - City:GUTHRIE
Practice Address - State:OK
Practice Address - Zip Code:73044-6863
Practice Address - Country:US
Practice Address - Phone:405-824-2320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-10
Last Update Date:2012-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)