Provider Demographics
NPI:1841092038
Name:HUDSON DAVIS, DEBRA N
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:N
Last Name:HUDSON DAVIS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 E 175TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44119-3137
Mailing Address - Country:US
Mailing Address - Phone:216-566-4797
Mailing Address - Fax:
Practice Address - Street 1:1220 E 175TH ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44119-3137
Practice Address - Country:US
Practice Address - Phone:216-566-4797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Single Specialty