Provider Demographics
NPI:1972308005
Name:DUDLEY, HADIE SHAYE
Entity type:Individual
Prefix:
First Name:HADIE
Middle Name:SHAYE
Last Name:DUDLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5524 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:OK
Mailing Address - Zip Code:73030-9671
Mailing Address - Country:US
Mailing Address - Phone:580-618-6626
Mailing Address - Fax:
Practice Address - Street 1:5524 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:DAVIS
Practice Address - State:OK
Practice Address - Zip Code:73030-9671
Practice Address - Country:US
Practice Address - Phone:580-618-6626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician