Provider Demographics
NPI:1811315807
Name:GIDES, JEANNE KUDER
Entity type:Individual
Prefix:MRS
First Name:JEANNE
Middle Name:KUDER
Last Name:GIDES
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 1:292 ROBINSON AVE
Mailing Address - Street 2:
Mailing Address - City:BARBERTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-3518
Mailing Address - Country:US
Mailing Address - Phone:330-753-1025
Mailing Address - Fax:330-745-8378
Practice Address - Street 1:292 ROBINSON AVE
Practice Address - Street 2:
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-3518
Practice Address - Country:US
Practice Address - Phone:330-753-1025
Practice Address - Fax:330-745-8378
Is Sole Proprietor?:No
Enumeration Date:2014-04-07
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool