Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | S.1803102 | OH |
NPI | 1003382391 |
---|---|
Provider Name | Brittany Hudak |
First Address | Willoughby, OH 44094-7875 |
Second Address | Cuyahoga Falls, OH 44221-2320 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2018 |
Last Update Date | 15/10/2018 |