Individual
MS. JENNIFER L DUDREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
954 EASTPORT CENTRE DR STE B, VALPARAISO, IN 46383-4456
(219) 286-6482
(219) 286-7367
Mailing address
954 EASTPORT CENTRE DR STE B, VALPARAISO, IN 46383-4456
(219) 286-6482
(219) 286-7367
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34006080A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000714946
ANTHEM
IN
Enumeration date
08/09/2010
Last updated
11/13/2020
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