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Individual

KRISTEN HUDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1040 MARKET ST, HENDERSON, KY 42420-4855
(270) 827-4652
(270) 831-1182
Mailing address
1040 MARKET ST, HENDERSON, KY 42420-4855
(270) 827-4652
(270) 831-1182

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1000
KY
103K00000X
Behavior Analyst

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7100174590
SCL WAIVER
KY
05
7100215710
KY
Enumeration date
01/20/2011
Last updated
11/05/2013
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