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Individual
KALLIE DUDA
Active
Individual
KALLIE DUDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW-C
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
28577
MD
104100000X
Social Worker
28577
MD
1041C0700X
Clinical Social Worker
Primary
28577
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28577
LICENSE
MD
Enumeration date
06/06/2022
Last updated
09/24/2024
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