Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | 7758 | CA |
NPI | 1013599364 |
---|---|
Provider Name | Allison Marie Hudson |
First Address | Los Angeles, CA 90064-4800 |
Second Address | Los Angeles, CA 90064-4800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2021 |
Last Update Date | 26/04/2021 |