| NPI | 1528495512 |
|---|---|
| Former Name | STEPHANIE LEE DUDAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 375148-1) |
| Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: NY 375148-1) |
| Enumeration Date | 2013-10-04 |
| Last Update Date | 2013-10-04 |