Individual
TRACEY DUDENHEFER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1454 RIDGECREST DR, SLIDELL, LA 70458-3142
(985) 645-3645
Mailing address
1454 RIDGECREST DR, SLIDELL, LA 70458-3142
(985) 645-3645
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6000
LA
Other
Enumeration date
03/20/2015
Last updated
03/20/2015
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