Healthcare Provider Details

I. General information

NPI: 1285325977
Provider Name (Legal Business Name): BRITTANI NICOLE HUDSON PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2023
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3507 STELLA BLUE DR
HYATTSVILLE MD
20782-2451
US

IV. Provider business mailing address

3507 STELLA BLUE DR
HYATTSVILLE MD
20782-2451
US

V. Phone/Fax

Practice location:
  • Phone: 310-415-6856
  • Fax:
Mailing address:
  • Phone: 310-415-6856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPY11873
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY20001739
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPY11873
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY20001739
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: