Individual
JUDY ALETHE RUDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
196 GLENWOOD DR, EAGLE POINT, OR 97524-8595
(541) 261-1763
(541) 210-5162
Mailing address
196 GLENWOOD DR, EAGLE POINT, OR 97524-8595
(541) 261-1763
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
L3625
OR
1041C0700X
Clinical Social Worker
Primary
L3625
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
L3625
CLINICAL SOCIAL WORK
OR
Enumeration date
08/07/2018
Last updated
09/28/2018
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