Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103K00000X | Behavior Analyst |
NPI | 1013263565 |
---|---|
Provider Name | Julie Hudson |
First Address | Tulsa, OK 74133-1725 |
Second Address | Sapulpa, OK 74066-6423 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2012 |
Last Update Date | 01/08/2012 |