Doctor Name: | PAMELA ROSE HUDSON |
NPI Number: | 1306010541 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 120 Main Ave N Park Rapids, MN - 564701810 |
Business Phone Number: | 2187327266 |
Business Fax Number: | 8004220863 |
Mailing Address: | 32068 Great Road, AKELEY |
State: | MN |
Postal Code: | 56433 |
Phone Number: | 2186524530 |
Fax Number: | |
NPI Enumeration Date: | 04/18/2008 |
NPI Last Update Date: | 04/18/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |