Individual
RONALD LEE DUDASH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSCCCSLP
Contact information
Practice address
19 W NEWTON ST, RICE LAKE, WI 54868-1744
(715) 234-2161
Mailing address
19 W NEWTON ST, RICE LAKE, WI 54868-1744
(715) 234-2161
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1402-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1402-154
SPEECH LANGAGE PATHOLOGY LICENSE
WI
05
—
42788600
—
WI
Enumeration date
05/04/2008
Last updated
05/04/2008
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