Individual
BREANNA TARA HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
115 PINE ST, BECKLEY, WV 25801-5349
(681) 296-7052
Mailing address
PO BOX 1153, BEAVER, WV 25813-1153
(681) 296-7052
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
04/22/2021
Last updated
04/22/2021
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