Individual
BO DUDLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CDCA
Contact information
Practice address
1320 WASHINGTON AVE, CLEVELAND, OH 44113-2333
(216) 781-0550
(216) 781-7501
Mailing address
1320 WASHINGTON AVE, CLEVELAND, OH 44113-2333
(216) 781-0550
(216) 781-7501
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
.152026
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
.152026
CHEMICAL DEPENDENCY PROFESSIONALS BOARD
OH
Enumeration date
03/26/2018
Last updated
03/26/2018
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