Individual
MR. JOHN GRADEN HUDSON II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, PLMHP
Contact information
Practice address
1941 S 42ND ST, SUITE 538, OMAHA, NE 68105-2939
(402) 344-7000
Mailing address
1115 LAFAYETTE DR, PAPILLION, NE 68046-2911
(402) 344-7000
(402) 344-8089
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
8192
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
815866000020974
—
NE
Enumeration date
12/01/2006
Last updated
07/09/2007
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