Provider Demographics
NPI:1811713084
Name:HUDSON, DEBORAH KAY (MA MT-BC, RIC)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:KAY
Last Name:HUDSON
Suffix:
Gender:F
Credentials:MA MT-BC, RIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 LAXTON RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-5294
Mailing Address - Country:US
Mailing Address - Phone:434-515-2041
Mailing Address - Fax:
Practice Address - Street 1:137 LAXTON RD STE 200
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-5294
Practice Address - Country:US
Practice Address - Phone:434-515-2041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0704017561101YM0800X
19218225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist