Provider Demographics
NPI:1386781565
Name:HUDSON, EMILY O (MA CCCSLP)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:O
Last Name:HUDSON
Suffix:
Gender:F
Credentials:MA CCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5922 BLUE MOUNTAIN CIR
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-2711
Mailing Address - Country:US
Mailing Address - Phone:217-415-0203
Mailing Address - Fax:
Practice Address - Street 1:5922 BLUE MOUNTAIN CIR
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503-2711
Practice Address - Country:US
Practice Address - Phone:217-415-0203
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.006250235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist