Doctor Name: | DR. JUDY WOLFE SPILLANE |
NPI Number: | 1225181928 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PH.D. |
License Number: | |
Business Practice Address: | 1152 S Main St Lakeport, CA - 954535517 |
Business Phone Number: | 7074331766 |
Business Fax Number: | 7079947349 |
Mailing Address: | 1152 S Main St, LAKEPORT |
State: | CA |
Postal Code: | 954535517 |
Phone Number: | 7074331766 |
Fax Number: | 7079947349 |
NPI Enumeration Date: | 01/18/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |