Provider Demographics
NPI:1245079094
Name:ADEN, SUDI
Entity type:Individual
Prefix:
First Name:SUDI
Middle Name:
Last Name:ADEN
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 1:4031 126TH PL
Mailing Address - Street 2:
Mailing Address - City:SAVAGE
Mailing Address - State:MN
Mailing Address - Zip Code:55378-1581
Mailing Address - Country:US
Mailing Address - Phone:763-328-7340
Mailing Address - Fax:
Practice Address - Street 1:4031 126TH PL
Practice Address - Street 2:
Practice Address - City:SAVAGE
Practice Address - State:MN
Practice Address - Zip Code:55378-1581
Practice Address - Country:US
Practice Address - Phone:763-328-7340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling