Provider Demographics
NPI:1992017339
Name:HUDSON, RACHAEL (LMT)
Entity Type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:
Last Name:HUDSON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12191 W 64TH AVE STE 306
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-4030
Mailing Address - Country:US
Mailing Address - Phone:303-249-8439
Mailing Address - Fax:
Practice Address - Street 1:12191 W 64TH AVE STE 306
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80004-4030
Practice Address - Country:US
Practice Address - Phone:303-249-8439
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO6158225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist