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1265688196
DUSTIN SHANE TUDOR
DU BOIS, PA
NPI
1265688196
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2008-08-12
Last Update Date
2008-08-12
Business Address
-- DUSTIN SHANE TUDOR MA
100 CALDWELL DR
DU BOIS, PA 15801-1152
Phone number: 814-371-1100
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Mailing Address
-- DUSTIN SHANE TUDOR MA
793 OLD ROUTE 119 HWY N
INDIANA, PA 15701-1372
Phone number: 724-465-5576
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