Dudley, Randell Scott
Dudley, Randell Scott is an individual health care provider with primary practice located at 17390 Dugdale Dr Ste 100 , South Bend IN 46635-1512. He recently has only one registered license in Behavioral Health & Social Service Providers / Behavior Technician, which is considered as his primary health care specialty. Dudley, Randell Scott can be contacted via phone (574) 400-2169.Contact Information
Primary practice address
17390 Dugdale Dr Ste 100
South Bend IN 46635-1512
Phone: (574) 400-2169
Fax: (317) 520-8200
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Behavior Technician | 106S00000X | RBT-20-109856 | Indiana |
Profile Details
| NPI number | 1477179513 |
|---|---|
| LBN Legal business name | Dudley, Randell Scott |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 24th, 2020 |
| Last updated | Jun 24th, 2020 - about 5 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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