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General NPI Number Information
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NPI Number | 1205384658
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Entity Type | Individual
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Provider Name | CAITLIN DUDENHOEFER LPC
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Gender | Female
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Dates
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Enumeration Date | 09/14/2016
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Last Update Date | 09/14/2016
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Provider Practice Location Address
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Address Line | 6832 CONVENT BLVD
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City | SYLVANIA
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State | OH
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Zip | 43560-4805
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Country | US
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Telephone | 419-882-4529
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Fax | 419-885-7612
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Provider Business Mailing Address
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Address Line | 6832 CONVENT BLVD
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City | SYLVANIA
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State | OH
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Zip | 43560-4805
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Country | US
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Telephone | 419-882-4529
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Fax | 419-885-7612
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | C1600344
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License Number State | OH
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