Individual
JACLYN HUDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
721 METROPOLITAN AVE STE C, LEAVENWORTH, KS 66048-1403
(913) 250-5452
Mailing address
152 HUNT RD, FORT LEAVENWORTH, KS 66027-1406
(719) 352-1406
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
17-04080
KS
225X00000X
Occupational Therapist
480015
KS
Other
Enumeration date
10/17/2022
Last updated
10/19/2022
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