Vivian Diane Hudson-Davis, Developmental Therap
Developmental Therapist in Glenwood, IL. Individual provider (NPI-1).
NPI number1295048817
StatusActive
Last updated in NPPESJul 24, 2010
Details
- NPI
- 1295048817
- Entity type
- Individual (NPI-1)
- Name
- Vivian Diane Hudson-Davis
- Credential
- Developmental Therap
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 24, 2010
- Last updated
- Jul 24, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 222Q00000X | Developmental Therapist | 1972388 | IL | Yes |
Practice location
242 S Dante AveGlenwood, IL 60425-2058
Phone 708-757-3560 · Fax 708-757-4799
Mailing address
242 S Dante AveGlenwood, IL 60425-2058
Phone 708-757-3560 · Fax 708-757-4799
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