Provider Demographics
NPI:1942791876
Name:HUDON, RENEE
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:HUDON
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 1:1925 S VAUGHN WAY APT 410
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-1365
Mailing Address - Country:US
Mailing Address - Phone:360-913-8650
Mailing Address - Fax:
Practice Address - Street 1:8670 WOLFF CT STE 205
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-3692
Practice Address - Country:US
Practice Address - Phone:303-425-7298
Practice Address - Fax:303-940-8330
Is Sole Proprietor?:No
Enumeration Date:2018-05-26
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0023671225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist