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General NPI Number Information
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NPI Number | 1720306525
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Entity Type | Organization
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Legal Business Name | HUDSON PSYCHOLOGICAL GROUP
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Dates
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Enumeration Date | 05/04/2010
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Last Update Date | 05/04/2010
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Provider Practice Location Address
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Address Line | 85 HOPPER AVE ROOM #7
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City | WALDWICK
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State | NJ
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Zip | 07463-1517
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Country | US
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Telephone | 973-931-2113
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 260
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City | WALDWICK
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State | NJ
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Zip | 07463-0260
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. CHRISTINE HUDSON
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Credential | PH.D.
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Telephone | 973-931-2113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 35SI00447900
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License Number State | NJ
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