Provider Demographics
NPI:1407038573
Name:DUDZINSKI, ANGELA SUE (OT)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:SUE
Last Name:DUDZINSKI
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 AIRPORT RD STE E
Mailing Address - Street 2:
Mailing Address - City:ARDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28704-8598
Mailing Address - Country:US
Mailing Address - Phone:828-684-7337
Mailing Address - Fax:
Practice Address - Street 1:142 AIRPORT RD STE E
Practice Address - Street 2:
Practice Address - City:ARDEN
Practice Address - State:NC
Practice Address - Zip Code:28704-8598
Practice Address - Country:US
Practice Address - Phone:828-684-7337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-30
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5629225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7301826Medicaid