Provider Demographics
NPI:1821697038
Name:HUDSON, INDIA
Entity Type:Individual
Prefix:
First Name:INDIA
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 1:860 NW 213TH TER APT 108
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33169-2077
Mailing Address - Country:US
Mailing Address - Phone:305-780-3998
Mailing Address - Fax:
Practice Address - Street 1:111 NW 183RD ST STE 404
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33169-4619
Practice Address - Country:US
Practice Address - Phone:305-741-0073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-19
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor