Healthcare Provider Details

I. General information

NPI: 1578149357
Provider Name (Legal Business Name): SUNNY HUDNALL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2021
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 6TH AVE W
HUNTINGTON WV
25701-0028
US

IV. Provider business mailing address

10 6TH AVE W
HUNTINGTON WV
25701-1716
US

V. Phone/Fax

Practice location:
  • Phone: 304-525-8014
  • Fax:
Mailing address:
  • Phone: 304-525-8014
  • Fax: 304-525-8026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-25-416989
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: