Individual
JENNIFER LEEANN HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4208 SE 24TH ST, DEL CITY, OK 73115-2529
(405) 219-9011
Mailing address
4208 SE 24TH ST, DEL CITY, OK 73115-2529
(405) 219-9011
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
1194701516
OK
Other
Enumeration date
12/07/2021
Last updated
12/07/2021
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