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Individual

THERESA ANN DUDLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW, CADC1

Contact information

Practice address
1904 ELM ST, SUITE 5, FOREST GROVE, OR 97116-2553
(503) 803-0601
Mailing address
PO BOX 902, FOREST GROVE, OR 97116-0902

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
01-11-18
OR
1041C0700X
Clinical Social Worker
L3637
OR

Other

Enumeration date
04/19/2007
Last updated
09/11/2025
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