Individual
MICHELLE MARIE HUDIMAC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED.
Contact information
Practice address
201 THORNBERRY BRANCH LN, DAYTONA BEACH, FL 32124-3652
(386) 872-4892
Mailing address
3785 MAPLE GROVE CT, PORT ORANGE, FL 32129-8618
(814) 288-9648
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Enumeration date
10/13/2014
Last updated
11/08/2019
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