Provider Demographics
NPI:1912106865
Name:DUDLEY, JULIA C (LCDC)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:C
Last Name:DUDLEY
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4225 WOODS PL
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602-7991
Mailing Address - Country:US
Mailing Address - Phone:325-692-2620
Mailing Address - Fax:
Practice Address - Street 1:4225 WOODS PL
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79602-7991
Practice Address - Country:US
Practice Address - Phone:325-692-2620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8642101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)