Individual
MRS. LISA LONG HUDGENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
NEW LIFE CENTER, 102 GINN ALTMAN AVE, STE C, HAMPTON, SC 29924
(803) 943-8175
Mailing address
102 GINN ALTMAN AVE STE C, HAMPTON, SC 29924-3963
(803) 943-2800
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
190166
—
SC
Enumeration date
11/01/2006
Last updated
09/26/2024
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