Dudley, Lori

Dudley, Lori is an individual health care provider with primary practice located at 4348 Electric Rd , Roanoke VA 24018-0720. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Dudley, Lori can be contacted via phone (540) 769-0976.

Contact Information

Primary practice address
4348 Electric Rd Roanoke VA 24018-0720
Phone: (540) 769-0976
Fax: (540) 857-5385
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 0810-003042 Virginia

Profile Details

NPI number 1477529972
LBN Legal business name Dudley, Lori
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 24th, 2006
Last updated Nov 2nd, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477529972 NPPES
Virginia MEDICAID 010047668
Virginia MEDICAID 010194644
Virginia MEDICAID 010194679
Virginia MEDICAID 7712910
Virginia MEDICAID 010194652
Virginia MEDICAID 010077656
Virginia MEDICAID 010077672

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