| Doctor Name: | HASANI KUDURA |
| NPI Number: | 1508022138 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LADAC |
| License Number: | 0081851 |
| Business Practice Address: | 530 Demoss Street Hidalgo Medical Services Inc Lordsburg, NM - 880452618 |
| Business Phone Number: | 5755428384 |
| Business Fax Number: | 5755428367 |
| Mailing Address: | 530 Demoss Street, Hidalgo Medical Services Inc LORDSBURG |
| State: | NM |
| Postal Code: | 880452618 |
| Phone Number: | 5755428384 |
| Fax Number: | 5755428367 |
| NPI Enumeration Date: | 08/04/2008 |
| NPI Last Update Date: | 09/26/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 0081851 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |