Organization
JOHN B HUDOME INNOVATIVE CONSULTING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN B HUDOME DCH, LCSW (OWNER)
(856) 438-5256
Entity
Organization
Contact information
Practice address
105 E MAIN ST, MAPLE SHADE, NJ 08052-2621
(856) 438-5256
Mailing address
105 E MAIN ST, MAPLE SHADE, NJ 08052-2621
(856) 438-5256
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
44SC01389300
NJ
261QM0855X
Adolescent and Children Mental Health Clinic/Center
44SC01389300
NJ
Other
Enumeration date
09/14/2009
Last updated
09/14/2009
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