Doctor Name: | KATHLEEN A JUDGE |
NPI Number: | 1073738241 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LICSW BCD |
License Number: | 089-0000039 |
Business Practice Address: | 164 Woodstock Ave Rutland, VT - 057013553 |
Business Phone Number: | 8027754500 |
Business Fax Number: | 8024224711 |
Mailing Address: | Po Box 14, KILLINGTON |
State: | VT |
Postal Code: | 057510014 |
Phone Number: | 8027754500 |
Fax Number: | 8024224711 |
NPI Enumeration Date: | 04/14/2007 |
NPI Last Update Date: | 09/21/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 089-0000039 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |