Provider Demographics
NPI:1366054058
Name:HUDSON, RACHEL JEAN (MSW)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:JEAN
Last Name:HUDSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4513 BARRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62711-7208
Mailing Address - Country:US
Mailing Address - Phone:217-816-2184
Mailing Address - Fax:
Practice Address - Street 1:114 E LINCOLN ST
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:IL
Practice Address - Zip Code:62220-2251
Practice Address - Country:US
Practice Address - Phone:217-816-2184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-23
Last Update Date:2020-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker