Provider Demographics
NPI:1831260413
Name:DUDLEY, ANNE MARIE (MED)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:MARIE
Last Name:DUDLEY
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:MARIE
Other - Last Name:NEE PELIKAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 185
Mailing Address - Street 2:47 PEARL ST
Mailing Address - City:ARENDTSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17303
Mailing Address - Country:US
Mailing Address - Phone:717-677-9729
Mailing Address - Fax:
Practice Address - Street 1:47 PEARL ST
Practice Address - Street 2:
Practice Address - City:ARENDTSVILLE
Practice Address - State:PA
Practice Address - Zip Code:17303
Practice Address - Country:US
Practice Address - Phone:717-677-9729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health