Laura Dudley, M.S., SLP-CF

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Jenison, MI

NPI 1871969659 · NPPES record last updated Aug 17, 2015

Key facts

NPI
1871969659
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
License
7101004778 (MI)
Practice address
7086 8TH Ave
Jenison, MI 49428-9352
Phone
(616) 667-9551
NPI assigned
Aug 17, 2015
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
7101004778MIMDStudent in an Organized Health Care Education/Training Program

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 7101004778 MI Yes

Addresses

Primary practice location

7086 8TH Ave
Jenison, MI 49428-9352

Mailing address

7086 8TH Ave
Jenison, MI 49428-9352

Other providers in Jenison, MI

All providers in Jenison, MI · Student in an Organized Health Care Education/Training Program in Michigan

Sources for this page

Verify at the official NPI Registry.