Provider Demographics
NPI:1972025971
Name:HUDSON, JULIE ANN
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
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 1:8340 NW 113TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-2136
Mailing Address - Country:US
Mailing Address - Phone:918-906-5864
Mailing Address - Fax:
Practice Address - Street 1:409 S FRETZ AVE
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73003-5570
Practice Address - Country:US
Practice Address - Phone:405-726-9808
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-11
Last Update Date:2017-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health