| Doctor Name: | MRS. JUDITH LYNN PESCH |
| NPI Number: | 1285956656 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 6082769 |
| Business Practice Address: | 386 Highway 91 Elizabethton, TN - 376436060 |
| Business Phone Number: | 4239465576 |
| Business Fax Number: | 4235423240 |
| Mailing Address: | 1801 Colonial Ridge Rd, JOHNSON CITY |
| State: | TN |
| Postal Code: | 376047626 |
| Phone Number: | 4239263075 |
| Fax Number: | 4235423240 |
| NPI Enumeration Date: | 02/25/2010 |
| NPI Last Update Date: | 02/25/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 6082769 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |