Provider Demographics
NPI:1144067745
Name:DUDLEY, KARI (LISW)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:
Last Name:DUDLEY
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 ALAN AVE SW
Mailing Address - Street 2:
Mailing Address - City:SWISHER
Mailing Address - State:IA
Mailing Address - Zip Code:52338-9617
Mailing Address - Country:US
Mailing Address - Phone:319-610-2673
Mailing Address - Fax:
Practice Address - Street 1:2240 9TH ST
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-1575
Practice Address - Country:US
Practice Address - Phone:319-800-5564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-10
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0745491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical