Individual
STACY A DUDARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
202 A STREET, ELGIN, OK 73538-3693
(580) 591-3693
Mailing address
10089 NE 120TH ST, ELGIN, OK 73538-3693
(580) 591-3693
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1919
OK
Other
Enumeration date
01/10/2011
Last updated
02/20/2019
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