| Doctor Name: | DR. JUDITH ELIZABETH AVERY |
| NPI Number: | 1013139427 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | APRN-BC, PHD |
| License Number: | BRN420174 |
| Business Practice Address: | 790 Governor Carlos Camacho Road Department Of Mental Health And Substance Abuse Tamuning, GU - 96913 |
| Business Phone Number: | 6716475347 |
| Business Fax Number: | 6716496948 |
| Mailing Address: | 415 Chalan San Antonio, Suite 262c TAMUNING |
| State: | GU |
| Postal Code: | 969133620 |
| Phone Number: | 6717774678 |
| Fax Number: | |
| NPI Enumeration Date: | 05/03/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WP0808X |
| License Number: | BRN420174 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |