| Doctor Name: | MRS. JENNIFER GL DUDICH |
| NPI Number: | 1093902033 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LISW S |
| License Number: | I0500023 |
| Business Practice Address: | 1950 Richmond Rd Lyndhurst, OH - 441243719 |
| Business Phone Number: | 2164488600 |
| Business Fax Number: | |
| Mailing Address: | Po Box 692, CHESTERLAND |
| State: | OH |
| Postal Code: | 440260692 |
| Phone Number: | 4402124278 |
| Fax Number: | |
| NPI Enumeration Date: | 10/03/2007 |
| NPI Last Update Date: | 11/29/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | I0500023 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |