Provider Demographics
NPI:1649971557
Name:DUDEK, ERIN
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:DUDEK
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 1:3053 HAMPSHIRE AVE S
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55426-3432
Mailing Address - Country:US
Mailing Address - Phone:612-990-1248
Mailing Address - Fax:
Practice Address - Street 1:4969 OLSON MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-5138
Practice Address - Country:US
Practice Address - Phone:763-575-8086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-16
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling