Provider Demographics
NPI:1245546324
Name:HUDSPETH, KAREN SUE (COTA)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:SUE
Last Name:HUDSPETH
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 HUDSPETH ROAD
Mailing Address - Street 2:
Mailing Address - City:DEWITT
Mailing Address - State:AR
Mailing Address - Zip Code:72042
Mailing Address - Country:US
Mailing Address - Phone:870-344-0123
Mailing Address - Fax:
Practice Address - Street 1:601 S UNION ST
Practice Address - Street 2:
Practice Address - City:DE WITT
Practice Address - State:AR
Practice Address - Zip Code:72042-2727
Practice Address - Country:US
Practice Address - Phone:870-946-1606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROT-A605174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist