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Individual

AMERISS DUDLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
113 CREEKRIDGE DRIVE, LEESBURG, GA 31763-7001, LEESBURG, GA 31763
(904) 638-6388
Mailing address
130 CORRIDOR RD UNIT 3292, PONTE VEDRA BEACH, FL 32004-7833
(904) 638-6388

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary

Other

Enumeration date
03/08/2023
Last updated
03/08/2023
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