Provider Demographics
NPI:1881030906
Name:HUDSON, NICOLE MARIE
Entity Type:Individual
Prefix:MS
First Name:NICOLE
Middle Name:MARIE
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 1:315 RECORD ST
Mailing Address - Street 2:103
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89512-3327
Mailing Address - Country:US
Mailing Address - Phone:775-348-8811
Mailing Address - Fax:
Practice Address - Street 1:315 RECORD ST
Practice Address - Street 2:103
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89512-3327
Practice Address - Country:US
Practice Address - Phone:775-348-8811
Practice Address - Fax:775-348-8830
Is Sole Proprietor?:No
Enumeration Date:2013-05-15
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor