Doctor Name: | MR. CHAD JUDY |
NPI Number: | 1821466376 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | SLP-2643 |
Business Practice Address: | 152 E Main Street, Suite 110 Rigby, ID - 83442 |
Business Phone Number: | 2088816242 |
Business Fax Number: | |
Mailing Address: | 152 E Main Street, Suite 110, RIGBY |
State: | ID |
Postal Code: | 83442 |
Phone Number: | 2088816242 |
Fax Number: | |
NPI Enumeration Date: | 09/14/2015 |
NPI Last Update Date: | 09/14/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP-2643 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |