Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | C.1400144 | OH |
NPI | 1003350729 |
---|---|
Provider Name | Patricia Dudley |
First Address | Akron, OH 44320-2766 |
Second Address | Akron, OH 44320-2766 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2016 |
Last Update Date | 14/12/2016 |