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NPI Code Detail

MEDICARE: JANICE M DUDASH LPC

MEDICARE:   JANICE M DUDASH  LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorOK

General Provider Information

NPI Number : 1508169566
Entity Type Code : Individual
Provider Name (Legal Business Name) : JANICE M DUDASH LPC
Provider Business Mailing Address
First Line : 11901 N MACARTHUR BLVD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73162-1806
Country : US
Telephone Number : 405-302-2522
Fax Number :
Provider Business Practice Location Address
First Line : 11901 N MACARTHUR BLVD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73162-1806
Country : US
Telephone Number : 405-302-2522
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2010
Last Update Date : 12/16/2015

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Directions to “ JANICE M DUDASH LPC” Practice Location

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