Provider Demographics
NPI:1992065296
Name:REAUX HUDSON, KENISHA LASHELL (LMSW)
Entity type:Individual
Prefix:MISS
First Name:KENISHA
Middle Name:LASHELL
Last Name:REAUX HUDSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MISS
Other - First Name:KENISHA
Other - Middle Name:LASHELL
Other - Last Name:REAUX HUDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:12658 MANSFIELD GLEN CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77014-1970
Mailing Address - Country:US
Mailing Address - Phone:832-729-0140
Mailing Address - Fax:
Practice Address - Street 1:12658 MANSFIELD GLEN CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014-1970
Practice Address - Country:US
Practice Address - Phone:832-729-0140
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX54954104100000X
TN8562104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker