Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | 3734 | MD |
NPI | 1033772272 |
---|---|
Provider Name | Dr. Stephanie Judd |
First Address | Chevy Chase, MD 20815-5223 |
Second Address | Chevy Chase, MD 20815-5223 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2019 |
Last Update Date | 14/04/2019 |