Provider Demographics
NPI:1235682113
Name:JONES-DUDLEY, MARGIE
Entity Type:Individual
Prefix:
First Name:MARGIE
Middle Name:
Last Name:JONES-DUDLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2019 E BIJOU ST # 1
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-5818
Mailing Address - Country:US
Mailing Address - Phone:719-473-1805
Mailing Address - Fax:719-302-5324
Practice Address - Street 1:2019 E BIJOU ST # 1
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-5818
Practice Address - Country:US
Practice Address - Phone:719-473-1805
Practice Address - Fax:719-302-5324
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-27
Last Update Date:2017-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)