Individual
CHANELL DOMONIQUE HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1308 SHERWOOD AVE, RICHMOND, VA 23220-1210
(804) 828-9897
Mailing address
5608 CRENSHAW RD APT 1334, RICHMOND, VA 23227-2520
(048) 677-3754
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904013177
VA
1041C0700X
Clinical Social Worker
112927
TX
1041C0700X
Clinical Social Worker
LC200003187
DC
Other
Enumeration date
10/08/2021
Last updated
10/08/2024
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