Dudley, Gary Edward

Dudley, Gary Edward is an individual health care provider with primary practice located at 2520 Windy Hill Rd Se Suite 203, Marietta GA 30067-8664. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Dudley, Gary Edward can be contacted via phone (770) 953-6401.

Contact Information

Primary practice address
2520 Windy Hill Rd Se Suite 203 Marietta GA 30067-8664
Phone: (770) 953-6401
Fax: (770) 953-6015
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PSY000520 Georgia

Profile Details

NPI number 1710057294
LBN Legal business name Dudley, Gary Edward
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2006
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710057294 NPPES
Georgia MEDICAID 000117961F
Georgia MEDICAID 000117961A
Georgia MEDICAID 000117961G
Georgia MEDICAID 000117961H

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