Provider Demographics
NPI:1972293405
Name:HUDD ALFORD, PAULA J (ATC)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:J
Last Name:HUDD ALFORD
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:J
Other - Last Name:HUDD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ATC
Mailing Address - Street 1:0N953 KILLEY LN
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-3920
Mailing Address - Country:US
Mailing Address - Phone:630-962-1079
Mailing Address - Fax:
Practice Address - Street 1:0N953 KILLEY LN
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-3920
Practice Address - Country:US
Practice Address - Phone:630-962-1079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0960006242255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer