=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154287159
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | VANESSA HUDSON LMT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/02/2026
-----------------------------------------------------
Last Update Date | 01/02/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 331 MAINE ST
-----------------------------------------------------
City | BRUNSWICK
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04011-3358
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-318-1026
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 578 POWHATAN RD
-----------------------------------------------------
City | OTISFIELD
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04270-6467
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 603-318-1026
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number | MT2681
-----------------------------------------------------
License Number State | ME
-----------------------------------------------------