Individual
JERRY E GUDORF
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
403 E MADISON ST, SOUTH BEND, IN 46617-2322
(574) 234-0061
(574) 283-1209
Mailing address
6026 S BRIDGETON LN, SOUTH BEND, IN 46614-6364
(574) 291-9507
(574) 283-1313
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34002240
IN
Other
Enumeration date
03/08/2006
Last updated
07/08/2007
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