Provider Demographics
NPI:1497924153
Name:DUDLEY THOMPSON, BARBARA (LPC LICENSED PASTORA)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:
Last Name:DUDLEY THOMPSON
Suffix:
Gender:F
Credentials:LPC LICENSED PASTORA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:166 SPRING HILL FARM RD
Mailing Address - Street 2:
Mailing Address - City:EDGECOMB
Mailing Address - State:ME
Mailing Address - Zip Code:04556
Mailing Address - Country:US
Mailing Address - Phone:207-882-7637
Mailing Address - Fax:
Practice Address - Street 1:166 SPRING HILL FARM RD
Practice Address - Street 2:
Practice Address - City:EDGECOMB
Practice Address - State:ME
Practice Address - Zip Code:04556
Practice Address - Country:US
Practice Address - Phone:207-882-7637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELP1446101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor