Individual
DOREEN DANICE HUDDLESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
928 EAST WAYNE ST, SUIT C, SOUTH BEND, IN 46617
(574) 286-0030
(574) 848-9571
Mailing address
P.O. BOX 941, BRISTOL, IN 46507-0941
(574) 286-0030
(574) 848-9571
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200528060A
—
IN
Enumeration date
02/25/2011
Last updated
02/25/2011
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