Individual
DIANE KAY HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D., BCBA
Contact information
Practice address
310 E BROADWAY AVE STE 8, JACKSON, WY 83001-8636
(801) 251-6219
Mailing address
PO BOX 2653, JACKSON, WY 83001-2653
(801) 251-6219
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1
A
—
Enumeration date
03/06/2013
Last updated
02/09/2023
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