Individual
REBECCA GUDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
610 N MICHIGAN ST, SUITE 200, SOUTH BEND, IN 46601-1077
(574) 232-1471
(574) 239-8511
Mailing address
610 N MICHIGAN ST, SUITE 200, SOUTH BEND, IN 46601-1077
(574) 232-1471
(574) 239-8511
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34002727A
IN
Other
Enumeration date
10/28/2010
Last updated
10/28/2010
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