Provider Demographics
NPI:1356653109
Name:TSCHUDY, JOSEPH DANIEL (MFT)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:DANIEL
Last Name:TSCHUDY
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4701 BURCH CREEK DR
Mailing Address - Street 2:
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84403-4123
Mailing Address - Country:US
Mailing Address - Phone:801-710-8301
Mailing Address - Fax:
Practice Address - Street 1:5150 S WASHINGTON BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:SOUTH OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84405-4506
Practice Address - Country:US
Practice Address - Phone:801-337-0067
Practice Address - Fax:801-337-0070
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-09
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT77058603904106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist