Individual
MYRIC HUDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
223 FERNWOOD DR STE A, BATON ROUGE, LA 70806-3130
(225) 923-3733
Mailing address
223 FERNWOOD DR STE A, BATON ROUGE, LA 70806-3130
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
251S00000
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
600964601
—
LA
Enumeration date
01/05/2016
Last updated
01/05/2016
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