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Individual

DR. KENNETH CURTIS DUDLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
1705 MAIN ST, SUITE 501, BAKER CITY, OR 97814-3453
(541) 523-4715
Mailing address
PO BOX 324, BAKER CITY, OR 97814-0324
(541) 523-4715

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1656
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
83346
OR
Enumeration date
07/11/2006
Last updated
07/08/2007
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