Individual
DUSTIN SHANE TUDOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
100 CALDWELL DR, DU BOIS, PA 15801-1152
(814) 371-1100
(814) 375-0120
Mailing address
793 OLD ROUTE 119 HWY N, INDIANA, PA 15701-1372
(724) 465-5576
(724) 465-6379
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
08/12/2008
Last updated
08/12/2008
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