Bradley Robert Hudson, LMFT | |
201 W Lakeway Rd Ste 902, Gillette, WY 82718-6345 | |
(307) 209-4649 | |
(307) 381-0493 |
Full Name | Bradley Robert Hudson |
---|---|
Gender | Male |
Speciality | Marriage & Family Therapist |
Location | 201 W Lakeway Rd Ste 902, Gillette, Wyoming |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1063922920 | NPI | - | NPPES |
922436337 | Other | EINS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
106H00000X | Marriage & Family Therapist | LMFT-234 (Wyoming) | Primary |
Entity Name | Renewal Therapy Of Wy, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1720857030 PECOS PAC ID: 5496198137 Enrollment ID: O20240208004535 |
Mailing Address | Practice Location Address |
---|---|
Bradley Robert Hudson, LMFT 201 W Lakeway Rd Ste 902, Gillette, WY 82718-6345 Ph: (307) 209-4649 | Bradley Robert Hudson, LMFT 201 W Lakeway Rd Ste 902, Gillette, WY 82718-6345 Ph: (307) 209-4649 |
Kristina Marie Leslie, LMFT-170 Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 3907 Chippewa Ave, Gillette, WY 82718 Phone: 949-922-3043 Fax: 307-363-4807 | |
Kyle D Tew, M.S. M.F.T. Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 501 S Burma Ave, Gillette, WY 82716 Phone: 307-688-1000 | |
Amy Himes, LMFT Couples Therapy Medicare: Not Enrolled in Medicare Practice Location: 501 S Burma Ave, Gillette, WY 82716 Phone: 307-688-8051 Fax: 307-688-5008 |