Individual
STEPHANIE DUDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3900 JERMANTOWN RD, FAIRFAX, VA 22030-4900
(703) 910-5006
Mailing address
3900 JERMANTOWN RD STE 250, FAIRFAX, VA 22030-4946
(703) 910-5006
(888) 314-6706
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119007318
VA
225X00000X
Occupational Therapist
116429
TX
Other
Enumeration date
09/17/2014
Last updated
11/20/2019
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