Individual
DR. CLIFTON ROBERT HUDSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
515 3RD AVE, SUITE 100, SOUTH CHARLESTON, WV 25303-1329
(304) 415-2299
(800) 983-2875
Mailing address
10 WINDSONG WAY, WINFIELD, WV 25213-9729
(304) 415-2299
(800) 983-2875
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
908
WV
103TC0700X
Clinical Psychologist
Primary
908
WV
103TF0200X
Forensic Psychologist
908
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810002673
—
WV
Enumeration date
08/10/2006
Last updated
09/30/2012
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