Healthcare Provider Details

I. General information

NPI: 1689581969
Provider Name (Legal Business Name): ADALIA DUDLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 S ROCK ST STE 100
GEORGETOWN TX
78626-2831
US

IV. Provider business mailing address

810 S ROCK ST STE 100
GEORGETOWN TX
78626-2831
US

V. Phone/Fax

Practice location:
  • Phone: 512-553-2432
  • Fax:
Mailing address:
  • Phone: 512-553-2432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: