Individual
KENNETH D DUDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
2420 E 25TH ST, IDAHO FALLS, ID 83404-7549
(208) 542-1026
(208) 528-2945
Mailing address
2420 E 25TH ST, IDAHO FALLS, ID 83404-7549
(208) 542-1026
(208) 528-2945
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LPC-5061
ID
Other
Enumeration date
08/09/2012
Last updated
08/09/2012
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