Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1041C0700X | Clinical Social Worker | 0904005897 | VA |
NPI | 1003013822 |
---|---|
Provider Name | Mrs. Verneka Chanette Hudson |
First Address | Newport News, VA 23608-3233 |
Second Address | Newport News, VA 23608-3233 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2007 |
Last Update Date | 13/07/2009 |