Doctor Name: | ANDREW JAMES HUDAK |
NPI Number: | 1174692172 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCPC |
License Number: | 47 LCPC |
Business Practice Address: | 309 Wisconsin Ave Attn:andy Whitefish, MT - 599372319 |
Business Phone Number: | 4068621112 |
Business Fax Number: | 4068621112 |
Mailing Address: | Po Box 1763, WHITEFISH |
State: | MT |
Postal Code: | 599371763 |
Phone Number: | 4068621112 |
Fax Number: | 4068621112 |
NPI Enumeration Date: | 11/06/2006 |
NPI Last Update Date: | 08/09/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 47 LCPC |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |