Individual
DIANA L WALL- DUDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2014 VANDALIA ST, COLLINSVILLE, IL 62234-4848
(618) 345-9536
(618) 345-9587
Mailing address
2014 VANDALIA ST, COLLINSVILLE, IL 62234-4848
(618) 345-9536
(618) 345-9587
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.009947
IL
Other
Enumeration date
11/05/2012
Last updated
02/24/2014
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