Provider Demographics
NPI:1821757345
Name:DUGDALE, LANA A (MS)
Entity Type:Individual
Prefix:
First Name:LANA
Middle Name:A
Last Name:DUGDALE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 CHESTNUT HILL RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01772-1002
Mailing Address - Country:US
Mailing Address - Phone:508-269-0321
Mailing Address - Fax:
Practice Address - Street 1:2 CHESTNUT HILL RD
Practice Address - Street 2:
Practice Address - City:SOUTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01772-1002
Practice Address - Country:US
Practice Address - Phone:508-269-0321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-13
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health