| NPI | 1912199977 | 
|---|---|
| Former Name | MISTY DAWN RUDIG | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34006480A) | 
| Additional Taxonomies | 104100000X Social Worker (Licence: IN 33005335A) | 
| Enumeration Date | 2007-08-14 | 
| Last Update Date | 2025-10-06 |