Provider Information for 1861004939
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PERRY HUDSON MSW
Sex: Male
NPI: 1861004939
Last Updated: 2020-08-20
Certification Date: 2020-08-20
Certification Date: 2020-08-20
Details
| Name | Value | ||||||||||||||
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| NPI | 1861004939 | ||||||||||||||
| Enumeration Date | 2020-08-20 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | YES | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | 5205 W 75TH AVE SCHERERVILLE, IN 46375-3414 United States Phone: 219-677-5168 | Fax: | ||||||||||||||
| Primary Practice Address | 521 E 86TH AVE STE H MERRILLVILLE, IN 46410-6236 United States Phone: 219-323-3311 | Fax: | ||||||||||||||
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