Provider Demographics
NPI:1952084154
Name:HUDSON, ISABELLA (MA, LMHC, ATR)
Entity Type:Individual
Prefix:
First Name:ISABELLA
Middle Name:
Last Name:HUDSON
Suffix:
Gender:F
Credentials:MA, LMHC, ATR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 S ORLANDO AVE APT C5
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-6441
Mailing Address - Country:US
Mailing Address - Phone:772-584-1108
Mailing Address - Fax:
Practice Address - Street 1:1140 S ORLANDO AVE APT C5
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-6441
Practice Address - Country:US
Practice Address - Phone:772-584-1108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH22581101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty