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NPI Code Detail

MEDICARE: AUNDREA DENISE HUDSON LMHC, NCC

MEDICARE: AUNDREA DENISE HUDSON LMHC, NCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorMH23135FL

General Provider Information

NPI Number : 1962270181
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUNDREA DENISE HUDSON LMHC, NCC
Provider Business Mailing Address
First Line : 4727 KEYSER LN
Second Line :
City : PACE
State : FL
Zip : 32571-1511
Country : US
Telephone Number : 850-324-7838
Fax Number :
Provider Business Practice Location Address
First Line : 9999 CHEMSTRAND RD
Second Line :
City : PENSACOLA
State : FL
Zip : 32514-2724
Country : US
Telephone Number : 850-471-3430
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/18/2023
Last Update Date : 12/18/2023

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