Stacey L Hudson, LMT, LPN
Massage Therapist in Juliette, GA. Individual provider (NPI-1).
NPI number1528651007
StatusActive
Last updated in NPPESFeb 16, 2021
Details
- NPI
- 1528651007
- Entity type
- Individual (NPI-1)
- Name
- Stacey L Hudson
- Credential
- LMT, LPN
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Feb 16, 2021
- Certification date
- Feb 16, 2021
- Last updated
- Feb 16, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225700000X | Massage Therapist | MT004176 | GA | Yes |
Practice location
971 Taylor RdJuliette, GA 31046-3431
Phone 706-476-0411
Mailing address
971 Taylor RdJuliette, GA 31046-3431
Phone 706-476-0411
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