Individual
LORI DUDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
4348 ELECTRIC RD, ROANOKE, VA 24018-0720
(540) 769-0976
(540) 857-5385
Mailing address
902 S JEFFERSON ST, ROANOKE, VA 24016-4404
(540) 853-0900
(540) 853-0511
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0810-003042
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010047668
—
VA
05
—
010077656
—
VA
05
—
010077672
—
VA
05
—
010194644
—
VA
05
—
010194652
—
VA
05
—
010194679
—
VA
05
—
7712910
—
VA
Enumeration date
02/24/2006
Last updated
11/02/2021
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