Individual
VIVIAN DIANE HUDSON-DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DEVELOPMENTAL THERAP
Contact information
Practice address
242 S DANTE AVE, GLENWOOD, IL 60425-2058
(708) 757-3560
(708) 757-4799
Mailing address
242 S DANTE AVE, GLENWOOD, IL 60425-2058
(708) 757-3560
(708) 757-4799
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
Primary
1972388
IL
Other
Enumeration date
07/24/2010
Last updated
07/24/2010
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