Individual
MS. LATASHA DUDLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BBA, M. ED.
Contact information
Practice address
3275 HUNTING CREEK PASS, DOUGLASVILLE, GA 30135-8469
(678) 927-5159
(770) 726-9645
Mailing address
109 ALTON DR, LAGRANGE, GA 30241-1879
(404) 397-8907
(770) 726-9645
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YS0200X
School Counselor
429007
GA
171M00000X
Case Manager/Care Coordinator
—
—
225C00000X
Rehabilitation Counselor
—
GA
225CA2400X
Assistive Technology Practitioner Rehabilitation Counselor
—
—
Other
Enumeration date
05/04/2011
Last updated
10/21/2019
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