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General NPI Number Information
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NPI Number | 1093632325
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Entity Type | Individual
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Provider Name | SHEILAH R DUDLEY LGSW
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Gender | Female
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Dates
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Enumeration Date | 06/29/2026
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Last Update Date | 06/29/2026
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Provider Practice Location Address
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Address Line | 2399 ARIEL ST N STE D
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City | MAPLEWOOD
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State | MN
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Zip | 55109-2202
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Country | US
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Telephone | 651-770-1311
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Fax | 651-770-1879
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Provider Business Mailing Address
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Address Line | 1344 SAINT PAUL AVE APT 7
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City | SAINT PAUL
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State | MN
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Zip | 55116-2752
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Country | US
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Telephone | 651-770-1311
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Fax | 651-770-1879
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 35731
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License Number State | MN
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