| Doctor Name: | JUDITH CAROL HENRIFARRY |
| NPI Number: | 1205137148 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMFT |
| License Number: | MFT 18906 |
| Business Practice Address: | 41943 Big Bear Blvd Big Bear Lake, CA - 923158980 |
| Business Phone Number: | 9098008848 |
| Business Fax Number: | 9098668580 |
| Mailing Address: | Po Box 131018, BIG BEAR LAKE |
| State: | CA |
| Postal Code: | 923158980 |
| Phone Number: | 9098008848 |
| Fax Number: | 9098668580 |
| NPI Enumeration Date: | 11/09/2010 |
| NPI Last Update Date: | 11/09/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MFT 18906 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |